OrganizationActive
Art of Modern Anesthesia PC
NPI 1063824969 · Certified Registered Nurse Anesthetist · Ogden, UT
Provider details
- NPI number
- 1063824969
- Entity type
- Organization
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Manardie Shimata, Owner(801) 392-0385
- License
- 2775864406 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3480 Washington Blvd Ste 105
Ogden, UT 84401-4149
Phone: (801) 392-0385
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1468
Bountiful, UT 84011-1468
Registry dates
- Enumerated
- 2014-05-27
- Last updated
- 2025-01-30
- Certified
- 2025-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.