Healthcare Provider Details

I. General information

NPI: 1932773678
Provider Name (Legal Business Name): SHERRIE IRVINE SMITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERRIE IRVINE

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6696 SOUTH 2500 EAST SUITE 2A
UINTAH UT
84405
US

IV. Provider business mailing address

6696 SOUTH 2500 EAST SUITE 2A
UINTAH UT
84405
US

V. Phone/Fax

Practice location:
  • Phone: 385-382-1555
  • Fax: 877-851-4180
Mailing address:
  • Phone: 385-382-1555
  • Fax: 877-851-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10643856-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number10643856-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: