Provider Demographics
NPI:1528323508
Name:ANDERSEN, LINDSEY MARIE (DNP)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MARIE
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5169 COTTONWOOD ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6767
Mailing Address - Country:US
Mailing Address - Phone:801-507-3513
Mailing Address - Fax:
Practice Address - Street 1:5169 COTTONWOOD ST
Practice Address - Street 2:SUITE 510
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6767
Practice Address - Country:US
Practice Address - Phone:801-507-3513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5320369-4405363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care