Healthcare Provider Details

I. General information

NPI: 1841129178
Provider Name (Legal Business Name): SHAUN MICHAEL BELLAND NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 W SOUTH JORDAN PKWY STE 450A
SOUTH JORDAN UT
84095-3946
US

IV. Provider business mailing address

406 W SOUTH JORDAN PKWY STE 450A
SOUTH JORDAN UT
84095-3946
US

V. Phone/Fax

Practice location:
  • Phone: 801-919-3008
  • Fax:
Mailing address:
  • Phone: 801-919-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8784309-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: