Individual
DZENIS MEHINOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9660 S 1300 E, SANDY, UT 84094-3762
(801) 727-2056
(770) 701-6675
Mailing address
PO BOX 3570, SALT LAKE CITY, UT 84110-3570
(801) 727-2056
(770) 701-6675
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
084069
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
5158976-4406
UT
367500000X
Certified Registered Nurse Anesthetist
AP118812
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212653401
—
TX
01
—
8200UA
BLUE CROSS BLUE SHIELD
TX
01
—
P00878101
RAILROAD MEDICARE
TX
Enumeration date
01/25/2010
Last updated
11/20/2021
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