Provider Demographics
NPI:1023803624
Name:SHERRIFF, BREEONAH ELAINE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:BREEONAH
Middle Name:ELAINE
Last Name:SHERRIFF
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10836 S GRESHAM DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-6228
Mailing Address - Country:US
Mailing Address - Phone:801-842-4451
Mailing Address - Fax:
Practice Address - Street 1:10836 S GRESHAM DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-6228
Practice Address - Country:US
Practice Address - Phone:801-842-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11741741-8900363LF0000X
UT11741741-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily