Brisma Paulina Anderson
Individual provider Active NPI Other Technician · West Jordan, UT
NPI 1780469023 · NPPES record last updated Aug 25, 2023
Key facts
- NPI
- 1780469023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 7625 S 3200 W Ste 2
West Jordan, UT 84084-2887 - Phone
- (801) 915-0359
- NPI assigned
- Aug 25, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
7625 S 3200 W Ste 2
West Jordan, UT 84084-2887
Mailing address
228 E 1200 S
Centerville, UT 84014-2219
Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.