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Individual

SHANE JAIMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
5097 S 900 E STE 100, SALT LAKE CTY, UT 84117-5725
(801) 851-5554
Mailing address
5097 S 900 E STE 100, SALT LAKE CTY, UT 84117-5725
(801) 851-5554

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10975826-4405
UT

Other

Enumeration date
12/17/2018
Last updated
11/28/2023
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