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Contact Information

SHALESE M KILLIAN, FNP-C
250 W 300 N
ROOSEVELT, UT84066-2336
 Phone: 435-722-4691
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Critical Care Medicine

163WC0200X
Indicates primary specialty

NPI Profile & details for SHALESE M KILLIAN · (Female)

NPI Number 1346875325
Status Active
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 03/10/2020
Last updated 03/21/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 9012696-3102
  • UT License # 9012696-4405
Hospital affiliation(s)
  • UINTAH BASIN MEDICAL CENTER - (Acute Care)
    250 WEST 300 NORTH (75-2)
    ROOSEVELT, UT 84066
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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