NPI 1861155228 · live from the CMS NPI Registry
Shane A Archibald, RN, DNP, APRN, FNP-C
Nurse Practitioner, Family in Bountiful, UT. National Provider Identifier 1861155228, active.
NPI record
| NPI | 1861155228 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 185 S 400 E Ste 100, Bountiful, UT 84010 |
| Practice phone | 801-397-6200 |
| Mailing address | Po Box 5546, Denver, CO 80217 |
| Enumerated | October 21, 2021 |
| Last updated | November 11, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | 7672413-4405 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.