Individual
MARY ELLEN SHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7078
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7078
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
325877-4405
UT
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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