Healthcare Provider Details

I. General information

NPI: 1881344778
Provider Name (Legal Business Name): JODI ANDERSEN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 RENAISSANCE TOWNE DR STE 460
BOUNTIFUL UT
84010-7672
US

IV. Provider business mailing address

1895 W DEEP CREEK RD
MORGAN UT
84050-9621
US

V. Phone/Fax

Practice location:
  • Phone: 801-200-2999
  • Fax: 385-252-3338
Mailing address:
  • Phone: 801-391-8736
  • Fax: 385-252-3338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number374064-3102
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number374064-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: