Matthew Bothell, BSN, RN
Registered Nurse in Provo, UT. Individual provider (NPI-1).
NPI number1912802489
StatusActive
Last updated in NPPESOct 13, 2026
Details
- NPI
- 1912802489
- Entity type
- Individual (NPI-1)
- Name
- Matthew Bothell
- Credential
- BSN, RN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 13, 2026
- Certification date
- Oct 13, 2026
- Last updated
- Oct 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 12124598-3102 | UT | Yes |
Other names
- Matt Bothell (Other Name)
Practice location
1244 Alpine WayProvo, UT 84606-5390
Phone 435-850-0004
Mailing address
1244 Alpine WayProvo, UT 84606-5390
Phone 435-850-0004
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