Individual
TYLER NATHAN MEMMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1766 W 800 S, NEPHI, UT 84648-5516
(435) 623-3000
Mailing address
5324 42ND STREET, COLUMBUS, NE 68601
(435) 660-0451
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101640
NE
Other
Enumeration date
06/09/2021
Last updated
03/20/2023
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