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General NPI Number Information
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NPI Number | 1992684062
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Entity Type | Individual
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Provider Name | KEVIN SHORTEN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 1385 S 3750 E
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City | SPANISH FORK
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State | UT
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Zip | 84660-6398
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Country | US
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Telephone | 801-831-1573
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Fax |
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Provider Business Mailing Address
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Address Line | 1385 S 3750 E
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City | SPANISH FORK
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State | UT
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Zip | 84660-6398
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Country | US
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Telephone | 801-831-1573
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12957350-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 12957350-3102
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License Number State | UT
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