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General NPI Number Information
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NPI Number | 1669343455
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Entity Type | Individual
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Provider Name | BRYDON ANDERSON RN
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Gender | Male
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | ADDRESS: 50 MEDICAL DR N
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-581-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 2287 E SUADA DR
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City | HOLLADAY
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State | UT
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Zip | 84124-1851
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Country | US
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Telephone |
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 13014913-3102
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License Number State | UT
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