Most Relevant Information
Provider Data
NPI Number: | 1003517343 |
Provider Name: | MISTY R SHIELDS |
Entity Type: | Individual |
Taxonomy Code: | 363LP0808X |
Specialty: | Nurse Practitioner |
License Number: | 6960909-8900 |
Most Important Dates
Enumeration Date: | 03/14/2023 |
Last Updated: | 03/14/2023 |
Provider Practice Location
1717 W PACKSADDLE CIR
BLUFFDALE
UT
840651299
Practice Location Phone/Fax
Phone: | 3605978320 |
Fax: |
Provider Mailing Location
1717 W PACKSADDLE CIR
BLUFFDALE
UT
840651299
Provider Mailing Phone/Fax
Phone: | 3605978320 |
Fax: |