Individual
DAVID B FARNWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1067 N 500 W, PROVO, UT 84604-3305
(801) 375-8049
(801) 374-9195
Mailing address
PO BOX 1727, PROVO, UT 84603-1727
(801) 375-8049
(801) 374-9195
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
216093-4406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
562302331007
—
UT
Enumeration date
04/11/2007
Last updated
07/08/2007
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