Individual
ROBERT DUSTIN BULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 N MAIN ST, RICHFIELD, UT 84701-2061
(435) 893-4100
Mailing address
1000 N MAIN ST, RICHFIELD, UT 84701-2061
(435) 893-4100
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6573583-4406
UT
367500000X
Certified Registered Nurse Anesthetist
AP60840896
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2097438
—
WA
Enumeration date
11/11/2014
Last updated
03/06/2023
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