Provider Demographics
NPI:1932773678
Name:SMITH, SHERRIE IRVINE (RN)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:IRVINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHERRIE
Other - Middle Name:
Other - Last Name:IRVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2950 N CHURCH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-6504
Mailing Address - Country:US
Mailing Address - Phone:801-369-8989
Mailing Address - Fax:
Practice Address - Street 1:2950 N CHURCH ST STE 101
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-6504
Practice Address - Country:US
Practice Address - Phone:801-369-8989
Practice Address - Fax:801-704-9741
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10643856-3102163WP0808X
UT10643856-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health