Healthcare Provider Details

I. General information

NPI: 1407787179
Provider Name (Legal Business Name): TRINA ELISE PERRAS-BIRD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W 300 N
ROOSEVELT UT
84066-2351
US

IV. Provider business mailing address

PO BOX 263
ALTAMONT UT
84001-0263
US

V. Phone/Fax

Practice location:
  • Phone: 435-722-4691
  • Fax:
Mailing address:
  • Phone: 435-722-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10383557-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: