CODY RANDY CHARLTON

FARMINGTON, NM
NPI1720182710
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: UT  5130028-4406)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: NM  CRNA-01505)
Enumeration Date2006-09-11
Last Update Date2021-10-26
Business Address
Mr. CODY RANDY CHARLTON CRNA
801 W MAPLE ST
FARMINGTON, NM 87401-5630
Phone number: 505-609-2258
Mailing Address
Mr. CODY RANDY CHARLTON CRNA
PO BOX 3570
SALT LAKE CITY, UT 84110-3570
Phone number: 801-727-2056