Individual
ABBEY JO BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CPNP, PMHNP-BC
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-1000
Mailing address
1138 S WEST TEMPLE, SALT LAKE CITY, UT 84101-3119
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
95-4659390
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
10785478-4405
UT
Other
Enumeration date
03/21/2019
Last updated
10/23/2023
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