Individual
SHAUNA BENNEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 SHEPARD LN, FARMINGTON, UT 84025-3934
(801) 447-8680
Mailing address
2101 E CRESTHILL DR, SALT LAKE CITY, UT 84117-4312
(801) 815-0999
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
54896403102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54896403102
RN LICENSE
UT
Enumeration date
02/22/2022
Last updated
04/25/2022
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