Individual
SHAUNE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8899 S 700 E STE 250, SANDY, UT 84070-1813
(801) 987-8800
Mailing address
8899 S 700 E STE 250, SANDY, UT 84070-1813
(801) 987-8800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201825-4405
UT
363LF0000X
Family Nurse Practitioner
201825-8900
UT
Other
Enumeration date
08/21/2020
Last updated
11/18/2025
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