Shirley Jean Bleak in Salt Lake City - Family
Shirley Jean Bleak - NPI 1124197512
Shirley Jean Bleak is a Family in Salt Lake City, Utah. Shirley Jean Bleak practices all healthcare services and medical treatments related to Family. The NPI Number for Shirley Jean Bleak is 1124197512. The last update date is 2019-01-15.
Shirley Jean Bleak's current location address is 5131 Cottonwood St, Salt Lake City, Utah. You can contact this provider via phone number 8012633415 and fax number 8012633428. The mailing address for Shirley Jean Bleak is 5131 Cottonwood St, Salt Lake City, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shirley Jean Bleak |
|---|---|
| Address | 5131 Cottonwood St, Salt Lake City, Utah |
| Phone Number | 8012633415 |
| Fax Number | 8012633428 |
| Sole Proprietor | N |
| Credentials | FNP-C, MSN |
NPI Number Detail
| NPI Number | 1124197512 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2019-01-15 |
Provider Mailing Address Detail
| Address | 5131 Cottonwood St |
|---|---|
| City | Salt Lake City |
| State | Utah (UT) |
| Post Code | 841075701 |
| Phone Number | 8012633415 |
| Fax Number | 8012633428 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 193402-4405 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Shirley Jean Bleak?
The Shirley Jean Bleak has been issued the NPI (National Provider Identifier) 1124197512 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Shirley Jean Bleak?
The Shirley Jean Bleak is physically situated at 5131 Cottonwood St, in the city of Salt Lake City, state of UT, with the postal code 841075701.
What is Shirley Jean Bleak's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Shirley Jean Bleak is Family, and the corresponding taxonomy classification code for this specialized field is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1124197512 to Shirley Jean Bleak?
The Shirley Jean Bleak received its 1124197512 assignment from the Centers for Medicare & Medicaid Services on 2006-11-07.
When was the information pertaining to Shirley Jean Bleak most recently updated or revised?
The details related to Shirley Jean Bleak, including its address, specialty, and other relevant information, were last updated or revised on 2019-01-15.