| Doctor Name: | MICHAEL R ANDERSON |
| NPI Number: | 1295992097 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SSW, LPN, RN |
| License Number: | 6685217-3101 |
| Business Practice Address: | 245 S 680 S Cedar City, UT - 847203509 |
| Business Phone Number: | 4355860213 |
| Business Fax Number: | 4358659428 |
| Mailing Address: | 474 W 200 N, Ste#300 ST GEORGE |
| State: | UT |
| Postal Code: | 847704505 |
| Phone Number: | 4356345600 |
| Fax Number: | 4359868700 |
| NPI Enumeration Date: | 05/20/2008 |
| NPI Last Update Date: | 06/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 164W00000X |
| License Number: | 6685217-3101 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Licensed Practical Nurse |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |