Individual
SHAWNTAE MARIE GAGNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
1660 W ANTELOPE DR STE 205, LAYTON, UT 84041-1165
(801) 917-6104
Mailing address
564 VALERIA DR, LAYTON, UT 84041-3314
(435) 730-5329
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
11772267-4405
UT
367A00000X
Advanced Practice Midwife
11772267-4402
UT
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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