Healthcare Provider Details

I. General information

NPI: 1699848341
Provider Name (Legal Business Name): TWANA RIGNEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 WILLIAMSBURG PARK CIR
SANDY UT
84070-0517
US

IV. Provider business mailing address

640 EAST WILLIAMSBURG PARK CIRCLE
SANDY UT
84070
US

V. Phone/Fax

Practice location:
  • Phone: 801-509-9919
  • Fax:
Mailing address:
  • Phone: 801-509-9919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: