Healthcare Provider Details

I. General information

NPI: 1003830761
Provider Name (Legal Business Name): SHARON A KORHEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 W 1000 N
SALT LAKE CITY UT
84116-2135
US

IV. Provider business mailing address

1105 W 1000 N
SALT LAKE CITY UT
84116-2135
US

V. Phone/Fax

Practice location:
  • Phone: 801-408-8626
  • Fax: 801-364-2436
Mailing address:
  • Phone: 801-408-8626
  • Fax: 801-364-2436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2048704405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number204870
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: