Individual
CASEY MCKAY TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3580 W 9000 S, WEST JORDAN, UT 84088-8812
(801) 601-2393
(801) 601-2258
Mailing address
2221 LAKESIDE BLVD STE 600, RICHARDSON, TX 75082-4416
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10832691-4406
UT
Other
Enumeration date
07/08/2024
Last updated
07/09/2024
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