Provider Demographics
NPI:1962066795
Name:BELNAP, SCOTT (APRN)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:BELNAP
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 W RED ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6936
Mailing Address - Country:US
Mailing Address - Phone:801-979-9888
Mailing Address - Fax:
Practice Address - Street 1:4823 W RED ADMIRAL DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-6936
Practice Address - Country:US
Practice Address - Phone:801-979-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8070966-8900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care