Provider Demographics
NPI:1578354627
Name:ANDERSON, SYDNEY ALYSE (PA-S)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:ALYSE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:ALYSE
Other - Last Name:BLASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2278 E LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2715
Mailing Address - Country:US
Mailing Address - Phone:602-499-4737
Mailing Address - Fax:
Practice Address - Street 1:800 W UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6703
Practice Address - Country:US
Practice Address - Phone:801-863-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program