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Individual

MR. KENYON JAMES BOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
133 N 500 W, HYRUM, UT 84319-1080
(435) 245-3443
Mailing address
133 N 500 W, HYRUM, UT 84319-1080
(435) 245-3443

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
376170-4408
UT

Other

Enumeration date
06/24/2011
Last updated
06/24/2011
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