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NPI Code Detail

MEDICARE: CODY SUE ANDERSON RN

MEDICARE: CODY SUE ANDERSON RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse7941529-3102UT

General Provider Information

NPI Number : 1235069493
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY SUE ANDERSON RN
Provider Business Mailing Address
First Line : 3278 S 520 W
Second Line :
City : NIBLEY
State : UT
Zip : 84321-6554
Country : US
Telephone Number : 307-399-4009
Fax Number :
Provider Business Practice Location Address
First Line : 90 E 200 N
Second Line :
City : LOGAN
State : UT
Zip : 84321-4034
Country : US
Telephone Number : 435-752-0750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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