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General NPI Number Information
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NPI Number | 1750368718
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Entity Type | Individual
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Provider Name | SUSANNA BEAN WEST CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 320 RIVER PARK DR STE 125
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City | PROVO
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State | UT
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Zip | 84604
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Country | US
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Telephone | 801-437-4500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1060
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City | SPRINGVILLE
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State | UT
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Zip | 84663-7060
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Country | US
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Telephone | 214-498-0233
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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 | 10652098-8901
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License Number State | UT
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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 | C.APN.0004131-C-CRNA
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License Number State | CO
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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 | 609788
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License Number State | TX
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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 | CRNA000363
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License Number State | NV
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