Healthcare Provider Details

I. General information

NPI: 1750255972
Provider Name (Legal Business Name): NATHANIEL BEAU SMITHSON PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 E BAMBERGER DR
AMERICAN FORK UT
84003-5504
US

IV. Provider business mailing address

1062 E BAMBERGER DR
AMERICAN FORK UT
84003-5504
US

V. Phone/Fax

Practice location:
  • Phone: 760-559-7038
  • Fax: 385-900-1718
Mailing address:
  • Phone: 760-559-7038
  • Fax: 385-900-1718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10921774-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: