Provider Demographics
NPI:1174831408
Name:ANDERSEN, BRITTNEY (APRN)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12433 FORT ST
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9363
Mailing Address - Country:US
Mailing Address - Phone:801-576-1086
Mailing Address - Fax:801-576-9796
Practice Address - Street 1:12433 FORT ST
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9363
Practice Address - Country:US
Practice Address - Phone:801-576-1086
Practice Address - Fax:801-576-9796
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT61133094405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner