Provider Demographics
NPI:1437991916
Name:HOTH, EDITH MARIE (MSN, PMHNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:MARIE
Last Name:HOTH
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, APRN
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:ALEXANDER-HOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, PMHNP-BC, APRN
Mailing Address - Street 1:3682 W IRIS GLEN CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-3432
Mailing Address - Country:US
Mailing Address - Phone:801-885-5859
Mailing Address - Fax:
Practice Address - Street 1:2120 S HWY 40
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032
Practice Address - Country:US
Practice Address - Phone:801-885-5859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5972527-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health