Individual
MRS. LAURIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, APRN
Contact information
Practice address
716 W 800 N STE 300, OREM, UT 84057-6300
(801) 224-0421
(801) 224-0821
Mailing address
716 W 800 N STE 300, OREM, UT 84057-6300
(801) 224-0421
(801) 224-0821
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
193396-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193396-4405
STATE LICENSE
UT
Enumeration date
03/08/2007
Last updated
07/08/2007
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