Individual
ETHAN B SHIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 E 4500 S STE 300, MURRAY, UT 84107-4502
(801) 261-3500
Mailing address
650 E 4500 S STE 300, MURRAY, UT 84107-4502
(801) 261-3500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5560934-4405
UT
Other
Enumeration date
07/17/2018
Last updated
04/27/2023
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