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Individual

LAURIE A NIEDEREE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9660 SOUTH 1300 EAST, ALTA VIEW HOSPITAL, SANDY, UT 84094
(801) 501-2600
(801) 733-5618
Mailing address
3340 NORTH CENTER ST, #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
181273-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100501271
NV
01
107006952102
IHC
UT
05
118915800
WY
01
1502954
UMWA
UT
01
2090168
UNITED HEALTHCARE
UT
01
264745
DESERET MUTUAL
UT
01
73541
PEHP
UT
05
806732900
ID
05
822462
AZ
01
870545614LN2
EDUCATORS MUTUAL
UT
01
9754
HEALTHY U
UT
01
QM0000075886
ALTIUS
UT
01
TPRA07467
MOLINA
UT
Enumeration date
10/04/2006
Last updated
10/15/2012
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