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General NPI Number Information
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NPI Number | 1619818986
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Entity Type | Individual
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Provider Name | CHANDRA ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 826 N 100 E STE 4B
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City | SPANISH FORK
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State | UT
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Zip | 84660-1241
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Country | US
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Telephone | 801-804-5682
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Fax |
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Provider Business Mailing Address
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Address Line | 1708 S 2940 E
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City | SPANISH FORK
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State | UT
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Zip | 84660-8942
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Country | US
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Telephone | 314-852-5355
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 8999489-3102
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License Number State | UT
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