| Shasta Nikita Mitchell, DNP | |
|
1875 S Redwood Rd, Salt Lake City, UT 84104-5112 | |
| (435) 764-0156 | |
| Not Available |
| Full Name | Shasta Nikita Mitchell |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 4 Years |
| Location | 1875 S Redwood Rd, Salt Lake City, Utah |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134680093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 6641648-4405 (Utah) | Primary |
| 163W00000X | Registered Nurse | 6641648-3102 (Utah) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Center For Human Potential Inc | 0749247849 | 12 |
| Entity Name | Center for Human Potential Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548239940 PECOS PAC ID: 0749247849 Enrollment ID: O20041209001115 |
| Mailing Address | Practice Location Address |
|---|---|
| Shasta Nikita Mitchell, DNP 1481 E Pioneer Rd, Draper, UT 84020-9623 Ph: Not Available | Shasta Nikita Mitchell, DNP 1875 S Redwood Rd, Salt Lake City, UT 84104-5112 Ph: (435) 764-0156 |
Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999 |
Madeline Ann Thayer, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3600 |
Ms. Eliza Dansie Parkin, RN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2218 S Dallin St, Salt Lake City, UT 84109 Phone: 801-673-7088 |
Crystal Marshall, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4460 S Highland Dr, Salt Lake City, UT 84124 Phone: 888-949-4864 |
Emma Fong, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3802 S 700 E, Salt Lake City, UT 84106 Phone: 801-264-6000 |
Ashlee Brynn Fenton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1160 E 3900 S Ste G200, Salt Lake City, UT 84124 Phone: 801-268-7766 |
Ms. Sharon A Korhel, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1105 W 1000 N, Salt Lake City, UT 84116 Phone: 801-408-8626 Fax: 801-364-2436 |