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Individual

SHANE RULON STRATFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, AG-ACNP

Contact information

Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Mailing address
PO BOX 571117, MURRAY, UT 84157-1117
(801) 507-9700
(801) 507-9705

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
79812274405
UT

Other

Enumeration date
08/23/2018
Last updated
08/23/2018
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