Organization
ART OF MODERN ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANARDIE FRANCIS SHIMATA CRNA (OWNER)
(801) 392-0385
Entity
Organization
Contact information
Practice address
3480 WASHINGTON BLVD STE 105, OGDEN, UT 84401-4149
(801) 392-0385
Mailing address
PO BOX 1468, BOUNTIFUL, UT 84011-1468
(801) 296-2113
(801) 296-1715
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2775864406
UT
Other
Enumeration date
05/27/2014
Last updated
01/30/2025
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