Individual
MR. MARK W HEDELIUS
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
(770) 701-6676
Mailing address
PO BOX 3750, SALT LAKE CITY, UT 84110-3750
(800) 748-4868
(770) 701-6676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8006124-3102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
8006124-4406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8006124-3102
DOPL
UT
Enumeration date
12/06/2018
Last updated
11/02/2023
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