Healthcare Provider Details

I. General information

NPI: 1316888746
Provider Name (Legal Business Name): MRS. TIANNA GRACE BITZ VALERIUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10894 S RIVER FRONT PKWY
SOUTH JORDAN UT
84095-5609
US

IV. Provider business mailing address

1398 W 12600 S
RIVERTON UT
84065-7019
US

V. Phone/Fax

Practice location:
  • Phone: 801-878-1200
  • Fax:
Mailing address:
  • Phone: 541-908-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: