Provider Demographics
NPI:1699848341
Name:RIGNEY, TWANA (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:TWANA
Middle Name:
Last Name:RIGNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 EAST WILLIAMSBURG PARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070
Mailing Address - Country:US
Mailing Address - Phone:801-509-9919
Mailing Address - Fax:
Practice Address - Street 1:640 WILLIAMSBURG PARK CIR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-0517
Practice Address - Country:US
Practice Address - Phone:801-509-9919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTP13474Medicare UPIN