Provider Demographics
NPI:1033805551
Name:CHEEVER, SHELLEY BRADFIELD (RN)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:BRADFIELD
Last Name:CHEEVER
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 1:7722 S 1130 E
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-2923
Mailing Address - Country:US
Mailing Address - Phone:801-694-5700
Mailing Address - Fax:
Practice Address - Street 1:7722 S 1130 E
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-2923
Practice Address - Country:US
Practice Address - Phone:801-694-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7002183-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily