Individual
SHELLY MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 N 1700 W, LAYTON, UT 84041-8803
(801) 773-4840
Mailing address
802 S 4100 W, OGDEN, UT 84404-8823
(801) 628-1171
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
330043-4405
UT
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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