Provider Demographics
NPI:1093384802
Name:EILER, SHELBY ANN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:ANN
Last Name:EILER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14463 S MUIRWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-8218
Mailing Address - Country:US
Mailing Address - Phone:801-414-2951
Mailing Address - Fax:
Practice Address - Street 1:166 E 5900 S STE B109
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7293
Practice Address - Country:US
Practice Address - Phone:385-275-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9420341-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner