Individual
MRS. STACIE MICHELLE IRELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
3402 E STONEHILL LN, SALT LAKE CITY, UT 84121-5864
(801) 884-9220
Mailing address
3402 E STONEHILL LN, SALT LAKE CITY, UT 84121-5864
(801) 884-9220
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
106402793102
UT
363LF0000X
Family Nurse Practitioner
Primary
10640279-4405
UT
Other
Enumeration date
06/01/2020
Last updated
12/20/2021
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