Provider Demographics
NPI:1902667041
Name:CRITTENDEN, SHAUNA (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:
Last Name:CRITTENDEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5843 W CENTURY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3030
Mailing Address - Country:US
Mailing Address - Phone:480-620-6200
Mailing Address - Fax:
Practice Address - Street 1:240 E CENTER ST
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-3107
Practice Address - Country:US
Practice Address - Phone:801-877-5801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10425780-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty