Organization
NIGHTLIGHT ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY HENRIE CRNA (OWNER)
(801) 747-8017
Entity
Organization
Contact information
Practice address
530 E 500 S, SALT LAKE CITY, UT 84102-2707
(801) 747-8017
Mailing address
PO BOX 2573, IDAHO FALLS, ID 83403-2573
(208) 525-2090
(208) 523-8978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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