| Shaun Gundersen, DNP, APRN, FNP-C | |
|
163 S Sr 112 Hwy Ste 106, Grantsville, UT 84029-5520 | |
| (435) 264-4164 | |
| (435) 264-4264 |
| Full Name | Shaun Gundersen |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 163 S Sr 112 Hwy Ste 106, Grantsville, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659721934 | NPI | - | NPPES |
| 1073795258 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 8635933-4405 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mountain West Medical Center | Tooele, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Shaun Gundersen Fnp Pllc | 6507251782 | 3 |
| Entity Name | Patrick Green Md Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518256650 PECOS PAC ID: 6204000102 Enrollment ID: O20111110000358 |
| Entity Name | Shaun Gundersen Fnp Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457002503 PECOS PAC ID: 6507251782 Enrollment ID: O20221206001435 |
| Mailing Address | Practice Location Address |
|---|---|
| Shaun Gundersen, DNP, APRN, FNP-C 163 S Sr 112 Hwy Ste 106, Grantsville, UT 84029-5520 Ph: (435) 264-4164 | Shaun Gundersen, DNP, APRN, FNP-C 163 S Sr 112 Hwy Ste 106, Grantsville, UT 84029-5520 Ph: (435) 264-4164 |
Tiffanii Sharee Johnson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 408 Zachary Way, Grantsville, UT 84029 Phone: 435-830-4936 | |
Janelle M Neu, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 163 S Sr 112 Hwy Ste 106, Grantsville, UT 84029 Phone: 435-264-4164 Fax: 435-264-4264 | |
Pamela Sue Smith, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 564 S Saddle Rd, Grantsville, UT 84029 Phone: 435-224-3124 |