Individual
WADE MOYLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6817642-1206
UT
364SE0003X
Emergency Clinical Nurse Specialist
6817642-1206
UT
364SF0001X
Family Health Clinical Nurse Specialist
Primary
6817642-1206
UT
Other
Enumeration date
01/14/2008
Last updated
06/11/2026
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