Healthcare Provider Details

I. General information

NPI: 1609790773
Provider Name (Legal Business Name): JOHN-DAVID RILEY MHA,MSN, APRN,FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOHN RILEY MSN,MSN,APRN, FNP-BC

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 E 20 S
SPANISH FORK UT
84660-6124
US

IV. Provider business mailing address

1799 E 20 S
SPANISH FORK UT
84660-6124
US

V. Phone/Fax

Practice location:
  • Phone: 801-616-0751
  • Fax:
Mailing address:
  • Phone: 801-616-0751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5811201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: