Provider Demographics
NPI:1316747595
Name:ROBERTS, MONTE LOUIS (PHD, DNP, RN)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:LOUIS
Last Name:ROBERTS
Suffix:
Gender:
Credentials:PHD, DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 RUSHTON ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-0721
Mailing Address - Country:US
Mailing Address - Phone:801-792-6204
Mailing Address - Fax:
Practice Address - Street 1:698 12TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-5877
Practice Address - Country:US
Practice Address - Phone:801-475-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV884690163WS0200X
UT4771368-3102163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool