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General NPI Number Information
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NPI Number | 1487207296
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Entity Type | Individual
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Provider Name | KATHERINE ELIZABETH ANDERSON OD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2019
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 566 E 3300 S UNIT 1803
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84106-4731
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Country | US
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Telephone | 207-217-4898
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 N FRANCES BLVD
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City | TUCSON
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State | AZ
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Zip | 85712-3559
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Country | US
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Telephone | 207-217-4898
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13475740-9934
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License Number State | UT
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