Individual
MARK HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 N TRIUMPH BLVD, LEHI, UT 84043-4999
(385) 345-3000
Mailing address
1274 W BRIDALWOOD LOOP, LEHI, UT 84043-4908
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8760841-3102
UT
367500000X
Certified Registered Nurse Anesthetist
8760841-4406
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
8760841-8901
UT
Other
Enumeration date
12/20/2018
Last updated
01/10/2019
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