Individual
LAWRENCE C VAN ATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 N HOSPITAL DR, PRICE, UT 84501-4218
(800) 748-4868
(801) 733-5872
Mailing address
PO BOX 981357, PARK CITY, UT 84098-1357
(435) 615-1514
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
215357-4406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107026171101
IHC
UT
01
—
2000575
UNITED HEALTH
UT
01
—
270041325LV2
EDUCATORS MUTUAL
UT
01
—
74393
PEHP
UT
01
—
809498
DESERET MUTUAL
UT
01
—
8567
HEALTHY U
UT
01
—
QM0000076612
ALTIUS
UT
Enumeration date
09/14/2006
Last updated
07/08/2007
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