Healthcare Provider Details

I. General information

NPI: 1942052055
Provider Name (Legal Business Name): JOY FELIZ SHEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY FELIZ BROWN

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 LAMOILLE HWY
ELKO NV
89801-4321
US

IV. Provider business mailing address

10433 S REDWOOD RD STE 2
SOUTH JORDAN UT
84095-8502
US

V. Phone/Fax

Practice location:
  • Phone: 435-773-2621
  • Fax: 775-299-3064
Mailing address:
  • Phone: 801-260-1919
  • Fax: 801-260-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3032
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number136844501206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: