Individual
SHANE A ARCHIBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, DNP, APRN, FNP-C
Contact information
Practice address
185 S 400 E STE 100, BOUNTIFUL, UT 84010-4862
(801) 397-6200
(801) 397-6201
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
(801) 475-3414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7672413-4405
UT
Other
Enumeration date
10/21/2021
Last updated
11/11/2022
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