Individual
SHANELL N RICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3725 W 4100 S, WEST VALLEY CITY, UT 84120-5411
(801) 965-3600
Mailing address
14198 S CROWN ROSE DR, HERRIMAN, UT 84096-6497
(385) 226-1059
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
5801043-3102
UT
363L00000X
Nurse Practitioner
Primary
1083278717
UT
Other
Enumeration date
04/29/2019
Last updated
09/23/2019
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