Provider Demographics
NPI:1699476051
Name:SWAPP, SHELLEY E
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:E
Last Name:SWAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2795 E ROBIDOUX RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-1134
Mailing Address - Country:US
Mailing Address - Phone:801-808-3551
Mailing Address - Fax:
Practice Address - Street 1:2795 E ROBIDOUX RD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-1134
Practice Address - Country:US
Practice Address - Phone:801-808-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist