Provider Demographics
NPI:1528610532
Name:WARREN, SHAWN (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:WARREN
Suffix:
Gender:M
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 N 900 W STE 200
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4153
Mailing Address - Country:US
Mailing Address - Phone:385-382-1555
Mailing Address - Fax:877-851-4180
Practice Address - Street 1:498 N 900 W
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4137
Practice Address - Country:US
Practice Address - Phone:385-382-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID62048363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health