Healthcare Provider Details

I. General information

NPI: 1477383099
Provider Name (Legal Business Name): MICHAEL ALLEN TURNER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 W 800 N
OREM UT
84057-3660
US

IV. Provider business mailing address

9708 N GRENADA LN
EAGLE MOUNTAIN UT
84005-4811
US

V. Phone/Fax

Practice location:
  • Phone: 307-760-1778
  • Fax:
Mailing address:
  • Phone: 307-760-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8033337-8901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: