Healthcare Provider Details

I. General information

NPI: 1962310060
Provider Name (Legal Business Name): SHERIDAWN NEILSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 N MAIN ST STE 1B
CEDAR CITY UT
84721-9812
US

IV. Provider business mailing address

PO BOX 180
PAROWAN UT
84761-0180
US

V. Phone/Fax

Practice location:
  • Phone: 435-572-4255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number6396577-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: