Provider Demographics
NPI:1346017167
Name:SUGGS, SHELBIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHELBIE
Middle Name:
Last Name:SUGGS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 W 2075 S
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9163
Mailing Address - Country:US
Mailing Address - Phone:801-564-7525
Mailing Address - Fax:
Practice Address - Street 1:927 W 2075 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9163
Practice Address - Country:US
Practice Address - Phone:801-564-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8259739-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT8259739-4405OtherUTAH DIVISION OF PROFESSIONAL LICENSING
UT8259739-8900OtherUTAH DEPARTMENT OF PROFESSIONAL LICENSING