Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Fuller, STUDENT

Individual provider Certified Registered Nurse Anesthetist · NPI 1407626617

Jonathan Fuller, STUDENT is a Certified Registered Nurse Anesthetist in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2024.

Licensed in
MA
In the registry since
2024

Practice location Address checks out

330 Brookline Ave
Boston, MA 02215-5491
Phone: (617) 667-3112
Fax: (617) 754-8791
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RN2384182 (MA)

Record details

NPI number1407626617
Entity typeIndividual (Type 1)
GenderMale
Credentials STUDENT
Sole proprietorNo
NPI enumeratedJanuary 8, 2024
Last updated in NPPESJuly 30, 2026
Certification dateJuly 30, 2026

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