MEDICARE: MARISSA SARHADI

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10224502-4405	UT
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	658510	NY

General Provider Information

NPI Number	:	1720480577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA SARHADI

Provider Business Mailing Address
First Line	:	5310 S REVERE DR
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84117-7230
Country	:	US
Telephone Number	:	385-414-5607
Fax Number	:

Provider Business Practice Location Address
First Line	:	5310 S REVERE DR
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84117-7230
Country	:	US
Telephone Number	:	385-414-5607
Fax Number	:

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

Provider Enumeration Date	:	09/24/2014
Last Update Date	:	04/21/2026

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Directions to “ MARISSA SARHADI ” Practice Location

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