Provider Demographics
NPI:1265442230
Name:TORMAN, RICHARD C (CRNA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:TORMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 SOMERSET CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-4240
Mailing Address - Country:US
Mailing Address - Phone:801-336-6594
Mailing Address - Fax:
Practice Address - Street 1:5475 S 500 E
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6905
Practice Address - Country:US
Practice Address - Phone:800-880-3566
Practice Address - Fax:801-733-5872
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332418-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTTPRA08658OtherMOLINA
UT68295OtherPEHP
UT190246100OtherUS DEPT OF LABOR
UT219512OtherALTIUS
UT60309OtherHEALTHY U
UTTPRA08658OtherMOLINA
UT219512OtherALTIUS
UT68295OtherPEHP