Healthcare Provider Details

I. General information

NPI: 1891766945
Provider Name (Legal Business Name): SHERYL LYNN SALMON R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S MAIN ST SUITE 300
SALT LAKE CITY UT
84101-3176
US

IV. Provider business mailing address

1414 MCCLELLAND ST
SALT LAKE CITY UT
84105-2408
US

V. Phone/Fax

Practice location:
  • Phone: 801-536-6500
  • Fax: 801-536-6520
Mailing address:
  • Phone: 801-487-6478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number2091593102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: