Healthcare Provider Details

I. General information

NPI: 1376137547
Provider Name (Legal Business Name): BETHANY ROBBINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 S 200 E
BRIGHAM CITY UT
84302-3387
US

IV. Provider business mailing address

770 S 200 E
BRIGHAM CITY UT
84302-3387
US

V. Phone/Fax

Practice location:
  • Phone: 435-723-0517
  • Fax: 435-723-0587
Mailing address:
  • Phone: 435-723-0517
  • Fax: 435-723-0587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10507393-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10507393-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: