Organization · NPI-2

Art Of Modern Anesthesia PC

Nurse Anesthetist, Certified Registered · Ogden, UT

NPI number1063824969
StatusActive
Last updated in NPPESJan 30, 2025

Details

NPI
1063824969
Entity type
Organization (NPI-2)
Legal business name
Art Of Modern Anesthesia PC
Organization subpart
No
Enumeration date
May 27, 2014
Certification date
Jan 30, 2025
Last updated
Jan 30, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered2775864406UTYes

Practice location

3480 Washington Blvd Ste 105
Ogden, UT 84401-4149

Phone 801-392-0385

Mailing address

Po Box 1468
Bountiful, UT 84011-1468

Phone 801-296-2113 · Fax 801-296-1715

Authorized official

Manardie Francis Shimata
Owner
8013920385

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