Healthcare Provider Details

I. General information

NPI: 1598690950
Provider Name (Legal Business Name): KAITLYN MARIE OTERO DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 W CENTER ST
OREM UT
84057-5207
US

IV. Provider business mailing address

1125 W CENTER ST
OREM UT
84057-5207
US

V. Phone/Fax

Practice location:
  • Phone: 801-903-5903
  • Fax: 801-515-0935
Mailing address:
  • Phone: 801-903-5903
  • Fax: 801-515-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13361649-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: