Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Scott Fulkerson, ACNP-BC, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1144500018

Justin Scott Fulkerson, ACNP-BC, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Plantation, Florida. Qualified in 2017, 9 years ago. Practices with Waukegan Clinic Corp, a 62-clinician group and works from 3 locations. Licensed in Florida, Illinois and South Carolina.

Years since qualifying
9
Licensed in
FL, IL, SC
In the registry since
2011
Specialties on file
4
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

6766 W Sunrise Blvd Ste 100
Plantation, FL 33313-6072
Phone: (954) 583-8472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1775 Dempster St, Park Ridge, IL 60068-1143 — (847) 723-2210
  • 4500 S Lancaster Rd, Dallas, TX 75216-7167 — (803) 730-2778

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 209009025 (IL)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 209-009025 (IL)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 18087 (SC)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 11018636 (FL)

Record details

NPI number1144500018
Entity typeIndividual (Type 1)
GenderMale
Credentials ACNP-BC , CRNA
Sole proprietorNo
NPI enumeratedAugust 24, 2011
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Waukegan Clinic Corp — 62 clinicians
Accepts Medicare assignment Not indicated
Practice locations5 on file with Medicare

Other providers in Plantation