Provider Demographics
NPI:1740949809
Name:RYAN C BARTHOLOMEW CRNA PC
Entity type:Organization
Organization Name:RYAN C BARTHOLOMEW CRNA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:801-400-8994
Mailing Address - Street 1:675 N 100 E
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-5698
Mailing Address - Country:US
Mailing Address - Phone:801-400-8994
Mailing Address - Fax:
Practice Address - Street 1:675 N 100 E
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-5698
Practice Address - Country:US
Practice Address - Phone:801-400-8994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty