Max H Shurtliff, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · West Jordan, UT
NPI 1851484489 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851484489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 212191-4406 (UT)
- Practice address
- 3580 W 9000 S
West Jordan, UT 84070 - Phone
- (801) 993-9527
- Fax
- (801) 733-5872
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merwin D. Rasmussen, PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Utah Pain Management PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 212191-4406 | UT | Yes |
Addresses
Primary practice location
3580 W 9000 S
West Jordan, UT 84070
Mailing address
3618 W 6000 S
Roy, UT 84067
Phone (801) 993-9527
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102600 | Other | UT | GEM |
| 293654 | Other | UT | DMBA |
| 39005 | Other | UT | PEHP |
| 870542403 84121 A003 | Other | UT | TRICARE |
| PR00993 | Other | UT | MOLINA |
| QMXAF01875 | Other | UT | ALTIUS |
| 107001189102 | Other | UT | IHC |
| 870542403SH1 | Other | UT | EDUCATORS MUTUAL |
Other providers in West Jordan, UT
- Shopko Stores Operating Co. LLC
- Shoptikal LLC
- Debbie Shorten
- Carlee Showers
- Lindsey Shumway
- Ala Shwani
- Richard Burton Sickelsmith
- Walker Sickler
- Gabriel Silva Cubas
- Wendy Silva
All providers in West Jordan, UT · Certified Registered Nurse Anesthetist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.