Individual
DEVERY ANN SHADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7123 W 8090 S, WEST JORDAN, UT 84081-5089
(801) 654-1993
Mailing address
7123 W 8090 S, WEST JORDAN, UT 84081-5089
(801) 654-1993
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10212033-4405
UT
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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