Provider Demographics
NPI:1922876606
Name:OUCH, SHAYLI (RN)
Entity Type:Individual
Prefix:
First Name:SHAYLI
Middle Name:
Last Name:OUCH
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 1:1314 PAMELA ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-6554
Mailing Address - Country:US
Mailing Address - Phone:801-529-6797
Mailing Address - Fax:
Practice Address - Street 1:1314 PAMELA ST
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-6554
Practice Address - Country:US
Practice Address - Phone:801-529-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12877087-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse