Healthcare Provider Details

I. General information

NPI: 1316747595
Provider Name (Legal Business Name): MONTE LOUIS ROBERTS PHD, DNP, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 12TH ST
OGDEN UT
84404-5877
US

IV. Provider business mailing address

1185 RUSHTON ST
OGDEN UT
84401-0721
US

V. Phone/Fax

Practice location:
  • Phone: 801-475-3700
  • Fax:
Mailing address:
  • Phone: 801-792-6204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number884690
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number4771368-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: