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General NPI Number Information
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NPI Number | 1023680519
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Entity Type | Individual
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Provider Name | BENJAMIN COREY GERUN CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 3000 N TRIUMPH BLVD
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City | LEHI
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State | UT
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Zip | 84043-4999
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Country | US
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Telephone | 385-345-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 715 CHERRY HILL DR
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2935
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Country | US
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Telephone | 801-400-8626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 7810
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 8281608-4406
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RNA243051
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C-APN.0004101-C-CRNA
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License Number State | CO
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