Jensen Willard, CRNA | |
3741 W 12600 S, Riverton, UT 84065-7215 | |
(801) 285-4000 | |
Not Available |
Full Name | Jensen Willard |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 3741 W 12600 S, Riverton, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1962087403 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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367500000X | Nurse Anesthetist, Certified Registered | 10643479 (Utah) | Primary |
Entity Name | Mountain West Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558391763 PECOS PAC ID: 9032018502 Enrollment ID: O20040103000057 |
Mailing Address | Practice Location Address |
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Jensen Willard, CRNA 1355 Elk Hollow Rd, North Salt Lake, UT 84054-3378 Ph: () - | Jensen Willard, CRNA 3741 W 12600 S, Riverton, UT 84065-7215 Ph: (801) 285-4000 |
Samantha Blair Walker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3741 W 12600 S, Riverton, UT 84065 Phone: 801-727-2056 Fax: 770-701-6675 | |
Henna Kealohilani Brown Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3741 W 12600 S, Riverton, UT 84065 Phone: 801-285-4000 | |
Larissa J Bruck, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3741 W 12600 S, Riverton, UT 84065 Phone: 801-285-4000 |