Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Tillotson

Individual provider Family Nurse Practitioner · NPI 1396532065

Andrea Tillotson is a Nurse Practitioner in Salt Lake City, Utah. Qualified in 2025, 1 year ago. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2025

Practice location Address checks out

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone: (801) 487-0451
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 6203483-4405 (UT)

Record details

NPI number1396532065
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 24, 2025
Last updated in NPPESDecember 16, 2025
Certification dateDecember 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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