Individual
NATHAN MICHAEL MABON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
170 N 1100 E, AMERICAN FORK, UT 84003-2096
(801) 855-3300
Mailing address
2327 S PARK ST, SALT LAKE CITY, UT 84106-1413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8675420-3102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
8675420-4406
UT
Other
Enumeration date
11/05/2020
Last updated
01/27/2021
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