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

Lisa Nicole Anderson, MD

Individual provider Surgery Physician · NPI 1992226021

Lisa Nicole Anderson, MD is a General Surgery in Provo, Utah. Graduated from Texas a & M University System, Hsc, College of Medicine in 2017, 9 years ago. Licensed in Ohio, Texas and Utah.

Years since qualifying
9
Trained at
Texas a & M University System, Hsc, College of Medicine
Licensed in
OH, TX, UT
In the registry since
2017
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 N 300 W Ste 101
Provo, UT 84604-3381
Phone: (801) 852-3460
Fax: (801) 852-3459
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 14242949-1205 (UT)
Surgical Oncology Physician Taxonomy 2086X0206X · Licence 35.149055 (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 664589 (TX)
Surgical Oncology Physician Taxonomy 2086X0206X · Licence V2686 (TX)

Record details

NPI number1992226021
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 28, 2017
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026
Mailing address3550 N University Ave Ste 250, Provo, UT 84604-6695

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolTEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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