MEDICARE: SHAYDELL ANN STAMPER LMT

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	225700000X	Massage Therapist	14279405-4701	UT

General Provider Information

NPI Number	:	1720923634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYDELL ANN STAMPER LMT

Provider Business Mailing Address
First Line	:	531 S 900 E APT A14
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2979
Country	:	US
Telephone Number	:	208-643-2014
Fax Number	:

Provider Business Practice Location Address
First Line	:	4455 S 700 E STE 201
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-3076
Country	:	US
Telephone Number	:	801-634-8434
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “ SHAYDELL ANN STAMPER LMT” Practice Location

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