Carla Lucile Applegate-Anderson

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Salt Lake City, UT

NPI 1245877448 · NPPES record last updated Dec 6, 2019

Key facts

NPI
1245877448
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
7044161-4505 (UT)
Practice address
2666 South 2000 East
Suite 101
Salt Lake City, UT 84109
Phone
(801) 691-7064
NPI assigned
Dec 6, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7044161-4505UTMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7044161-4505 UT Yes

Addresses

Primary practice location

2666 South 2000 East
Suite 101
Salt Lake City, UT 84109

Mailing address

2666 S 2000 E Ste 101
Salt Lake City, UT 84109-1721
Phone (801) 691-7064

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Psychiatric/Mental Health Nurse Practitioner in Utah

Sources for this page

Verify at the official NPI Registry.