Individual
LYNDSAY ANNE WIXOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
2000 CIRCLE OF HOPE DR # 1950, SALT LAKE CITY, UT 84112-5550
(801) 971-8987
Mailing address
803 S 700 E, SALT LAKE CITY, UT 84102-3505
(801) 971-8987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8732025-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
8732025-4405
UT
Other
Enumeration date
06/25/2019
Last updated
12/20/2021
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