Organization
MT NEBO ANESTHESIA ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVON D PETERSON CRNA (PRESIDENT)
(800) 748-4868
Entity
Organization
Contact information
Practice address
48 W 1500 N, NEPHI, UT 84648-8900
(435) 623-3000
Mailing address
PO BOX 3810, SALT LAKE CITY, UT 84110-3810
(800) 748-4868
(770) 701-6674
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
08/08/2006
Last updated
01/24/2019
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