Samuel Mark Bertoch, FNP-C

Nurse Practitioner · Roosevelt, UT

Individual Active NPI

NPI number 1417525544

Practice location

2750 North 2762 West
Roosevelt, UT 84066
Phone
(435) 722-9250

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NPI record

NPI
1417525544
Entity type
Individual (Type 1)
Enumeration date
June 15, 2021
Last updated
June 15, 2021
Certified
April 2, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X 327174-4405 UT

About Samuel Bertoch

Samuel Mark Bertoch, FNP-C is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 2750 North 2762 West, Roosevelt, UT 84066. The NPI number 1417525544 was assigned on June 15, 2021 and the record was last updated on June 15, 2021.

Samuel Bertoch lists a license in the registry: #327174-4405 (UT) for Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Samuel Mark Bertoch, FNP-C?

The NPI number is 1417525544.

What is the phone number of Samuel Bertoch?

The phone number listed for the practice location is (435) 722-9250.

Where is Samuel Bertoch located?

2750 North 2762 West, Roosevelt, UT 84066.

What is the taxonomy code for Samuel Bertoch?

The primary taxonomy code is 363L00000X – Nurse Practitioner.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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