Individual
MS. ABBY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(866) 415-6556
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
806893
NY
363L00000X
Nurse Practitioner
Primary
11813053-4405
UT
363LP0200X
Pediatric Nurse Practitioner
0024188152
VA
363LP0200X
Pediatric Nurse Practitioner
11813053-4405
UT
Other
Enumeration date
08/09/2021
Last updated
12/18/2025
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