=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295656429
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOZO FAMILY WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2026
-----------------------------------------------------
Last Update Date | 07/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 826 N 100 E STE 4B
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660-1241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-804-5682
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 826 N 100 E STE 4B
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660-1241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-804-5682
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHANDRA ANDERSON
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 314-852-5355
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------