MEDICARE: TIANA TRENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07191995	OTHER		N/A

General Provider Information

NPI Number	:	1700585817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA TRENT

Provider Business Mailing Address
First Line	:	277 W 13490 S APT A411
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-7276
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W BELLWOOD LN STE 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-4494
Country	:	US
Telephone Number	:	702-857-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	01/14/2026

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Directions to “ TIANA TRENT ” Practice Location

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