SHAUN GUNDERSEN (NPI# 1659721934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659721934 |
| Entity Type | Individual |
| Full Name | SHAUN GUNDERSEN |
| Credential | FNP-C |
| Practice Address |
348 E 4500 S Ste 300 Salt Lake City UT 84107-8535 |
| Mailing Address |
Po Box 198560 Atlanta GA 30384-8560 |
| Practice Telephone | 8012662777 |
| Practice Fax Number | 8012661377 |
| Mailing Telephone | 8012662777 |
| Mailing Fax Number | 8012661377 |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2019-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
8635933-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1073795258 | 05 |
| Street Address |
348 E 4500 S STE 300 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-8535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861751794 | Rachel Allyson Tangaro | Family Medicine | 348 E 4500 S Ste 300, Salt Lake City, UT 84107 | 2012-05-12 |
| 1043741929 | Bradley M Watts | Family Medicine | 348 E 4500 S Ste 300, Salt Lake City, UT 84107-8535 | 2017-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204590 | Gabrielle Sleater Lewis | Nurse Practitioner | 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 | 2020-11-01 |
| 1962019596 | Freya Kristen Landesman | Nurse Practitioner | 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 | 2020-09-28 |
| 1568075604 | Michelle L Davis | Nurse Practitioner | 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 | 2020-08-28 |
| 1518583988 | Melanie Elise Harris | Nurse Practitioner | 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 | 2020-06-22 |
| 1295359651 | Julie Nielsen | Nurse Practitioner | 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 | 2020-06-02 |
| 1770112138 | Justin Henderson | Nurse Practitioner | 3851 S Birch Dr, Salt Lake City, UT 84109-3742 | 2020-04-07 |
| 1346885845 | Anita Hui Lucente | Nurse Practitioner | 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 | 2019-11-08 |
| 1841844057 | Mayra Ibeth Vences | Nurse Practitioner | 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 | 2019-07-25 |
| 1710549928 | Jenny Farley Mason | Nurse Practitioner | 4179 S Monarch Way, Salt Lake City, UT 84124-3168 | 2019-07-08 |
| 1144889940 | Amy Jackson Gilbert | Nurse Practitioner | 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 | 2019-06-06 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
Please comment or provide details below to improve the information on SHAUN GUNDERSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.