Individual
MS. TRACIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
DEPARTMENT OF PHARMACY SERVICES, 50 NORTH MEDICAL DRIVE RM A050, SALT LAKE CITY, UT 84132-0001
(801) 585-3965
Mailing address
DEPARTMENT OF PHARMACY SERVICES, 50 NORTH MEDICAL DRIVE RM A050, SALT LAKE CITY, UT 84132-0001
(801) 585-3965
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
378182-3102
UT
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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