Healthcare Provider Details

I. General information

NPI: 1346993193
Provider Name (Legal Business Name): BRYCE GOSNEY PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2132 N ROBINS DR STE 300
LAYTON UT
84041-7077
US

IV. Provider business mailing address

3785 HARRISON BLVD STE 4
OGDEN UT
84403-2072
US

V. Phone/Fax

Practice location:
  • Phone: 801-821-2333
  • Fax:
Mailing address:
  • Phone: 801-686-8488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95019258
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13183565-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: