Individual
LORETTA SHUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.M., R.N., LDEM
Contact information
Practice address
5319 S 500 E, OGDEN, UT 84405
(801) 917-6104
Mailing address
431 E 2700 N, NORTH OGDEN, UT 84414-2332
(801) 628-4573
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
218152-3102
UT
176B00000X
Midwife
Primary
218152-3400
UT
Other
Enumeration date
05/02/2017
Last updated
11/01/2018
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