Provider Demographics
NPI:1881038933
Name:DEYETTE, SHEILA ARLENE (PHD,APRN,PMHCNS-BC)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:ARLENE
Last Name:DEYETTE
Suffix:
Gender:F
Credentials:PHD,APRN,PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8925 S COLD WATER DR
Mailing Address - Street 2:APT. 1138
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-1883
Mailing Address - Country:US
Mailing Address - Phone:203-858-2121
Mailing Address - Fax:
Practice Address - Street 1:RUSSELL MURDOCK
Practice Address - Street 2:50 NORTH MEDICAL DR
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8227013-4405364SP0808X
UT8227013-8900364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health