Provider Demographics
NPI:1639157662
Name:SEELEY, SHARON (RN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:SEELEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 HIGHLAND DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3543
Mailing Address - Country:US
Mailing Address - Phone:801-273-1085
Mailing Address - Fax:801-273-4097
Practice Address - Street 1:4460 HIGHLAND DR
Practice Address - Street 2:SUITE #100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-3543
Practice Address - Country:US
Practice Address - Phone:801-273-1085
Practice Address - Fax:801-273-4097
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT962942403102163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health