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General NPI Number Information
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NPI Number | 1255952438
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Entity Type | Individual
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Provider Name | ASHLEY MANTLE APRN
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Gender | Female
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | UNIVERSITY OF UTAH HOSPITAL 50 N MEDICAL DRIVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-581-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 9246 S WASATCH MEADOWS DR
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City | WEST JORDAN
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State | UT
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Zip | 84088-2620
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Country | US
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Telephone | 801-432-7643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 6753909-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 6753909-4405
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 6753909-4405
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License Number State | UT
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