NPI 1184083826

Dirk Bradley Bahoravitch, MSNCRNA

Practitioner Certified Registered Nurse Anesthetist Provo, UT

Practice location

Address: 1067 N 500 W, Provo, UT 84604-3305
Phone: (801) 374-0354
Mailing address: 264 N 1020 E, American Fork, UT 84003-2957

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 53485 (ID)

Other Nurse Anesthetist, Certified Registered providers in Utah →

Registry record

NPI: 1184083826
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Feb 2016
Record last updated: 19 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.