Individual
SUSAN K. SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 587-9244
Mailing address
PO BOX 413021, SALT LAKE CITY, UT 84141-3021
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
196451-4405
UT
Other
Enumeration date
11/06/2006
Last updated
12/02/2013
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