Healthcare Provider Details

I. General information

NPI: 1932353653
Provider Name (Legal Business Name): SHEREEN ZAUGG APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2008
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 N 2000 W #203
FARR WEST UT
84404-9219
US

IV. Provider business mailing address

PO BOX 176
SHELLEY ID
83274-0176
US

V. Phone/Fax

Practice location:
  • Phone: 801-689-3389
  • Fax: 801-689-2320
Mailing address:
  • Phone: 801-689-3389
  • Fax: 801-689-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4942688-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: