Individual
SHANNON HARDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7130
Mailing address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7130
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
333475-8900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
01/16/2014
Last updated
08/25/2015
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