MEDICARE: DERECK SHIFFLET

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1104776798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERECK SHIFFLET

Provider Business Mailing Address
First Line	:	1094 W 2500 S
Second Line	:
City	:	VERNAL
State	:	UT
Zip	:	84078-4658
Country	:	US
Telephone Number	:	435-790-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1094 W 2500 S
Second Line	:
City	:	VERNAL
State	:	UT
Zip	:	84078-4658
Country	:	US
Telephone Number	:	435-789-2588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

Similar Medicare Providers

1487456513 — MEAGAN SWEET NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Practice Location Address:

1094 W 2500 S
VERNAL, UT
84078-4658

Practice Phone: 435-790-2588
Practice Fax:

1891580015 — OLIVIA RAY POPE
Practice Location Address:

1094 W 2500 S
VERNAL, UT
84078-4658

Practice Phone: 435-789-2588
Practice Fax:

1538011481 — IZABELLA STAGG
Practice Location Address:

390 W MAIN ST # 100
VERNAL, UT
84078-2508

Practice Phone: 435-219-1603
Practice Fax:

1598615254 — LEXIE CHRISTENSEN
Practice Location Address:

1293 W HIGHWAY 40 STE 2
VERNAL, UT
84078-2923

Practice Phone: 435-789-2588
Practice Fax:

1659222040 — CRAIG DOUGLAS NIELSEN
Practice Location Address:

150 W 100 N
VERNAL, UT
84078-2036

Practice Phone: 435-789-3342
Practice Fax: 435-781-2628

1194721704 — JERRY D. KULLAND P.T.
Practice Location Address:

1180 N VERNAL AVE , STE 3
VERNAL, UT
84078-4819

Practice Phone: 435-789-0022
Practice Fax:

Directions to “ DERECK SHIFFLET ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.