Individual
SHAUN GUNDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, FNP-C
Contact information
Practice address
163 S SR 112 HWY STE 106, GRANTSVILLE, UT 84029-5520
(435) 264-4164
(435) 264-4264
Mailing address
163 S SR 112 HWY STE 106, GRANTSVILLE, UT 84029-5520
(435) 264-4164
(435) 264-4264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8635933-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073795258
—
UT
Enumeration date
06/16/2016
Last updated
04/24/2024
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