Healthcare Provider Details

I. General information

NPI: 1760750368
Provider Name (Legal Business Name): DARIN WESLEY BLOOMFIELD CRNA, MHS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 WHITE SAGE AVE
DELTA UT
84624-8937
US

IV. Provider business mailing address

PO BOX 30180
SALT LAKE CITY UT
84130-0180
US

V. Phone/Fax

Practice location:
  • Phone: 435-864-5591
  • Fax:
Mailing address:
  • Phone: 435-864-5591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number6800670-3102
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6800670-4406
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: