Healthcare Provider Details

I. General information

NPI: 1821596701
Provider Name (Legal Business Name): ROBERT DEAN BARTLETT DNP, AGACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9450 S 1300 E
SANDY UT
84094-5555
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-314-2400
  • Fax:
Mailing address:
  • Phone: 801-314-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number7986302-4405
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7986302-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: