MRS. SHIRLEY JEAN BLEAK FNP-C MSN RNC NPI 1124197512

NPI Information

MRS. Shirley Jean Bleak, FNP-C, MSN, RNC is a family nurse practitioner in Salt Lake City, UT with 26 years of experience. MRS. Shirley Jean Bleak, FNP-C, MSN, RNC NPI is 1124197512. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5131 COTTONWOOD ST
L-2
SALT LAKE CITY, UT
ZIP 84107-701
Phone: (801) 263-3415
Fax: (801) 263-3428

The NPI 1124197512 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 1/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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