Provider Demographics
NPI:1821892217
Name:ANDERSON, SKYLER MICHON
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:MICHON
Last Name:ANDERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12246 S BRINLEY PEAK CT
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-3184
Mailing Address - Country:US
Mailing Address - Phone:801-574-1547
Mailing Address - Fax:
Practice Address - Street 1:12246 S BRINLEY PEAK CT
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-3184
Practice Address - Country:US
Practice Address - Phone:801-574-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program