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General NPI Number Information
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NPI Number | 1649935693
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Entity Type | Individual
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Provider Name | SHYLER BISCHOF DNP PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 110 S MAIN ST
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2631
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Country | US
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Telephone | 801-900-4670
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Fax |
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Provider Business Mailing Address
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Address Line | 276 N 240 E
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City | VINEYARD
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State | UT
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Zip | 84059-2609
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Country | US
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Telephone | 801-400-1722
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 8382095-4405
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License Number State | UT
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