Individual
TIMOTHY J ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
1203 N COLORADO ST, SLC, UT 84116-1662
(801) 913-6298
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9814402-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
9814402-4405
UT
Other
Enumeration date
04/09/2021
Last updated
12/03/2021
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