Provider Demographics
NPI:1801225081
Name:THOMPSON, TRINETTE (CPM, LDEM)
Entity Type:Individual
Prefix:
First Name:TRINETTE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W 170 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4645
Mailing Address - Country:US
Mailing Address - Phone:801-225-5668
Mailing Address - Fax:801-434-8704
Practice Address - Street 1:230 W 170 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4645
Practice Address - Country:US
Practice Address - Phone:801-225-5668
Practice Address - Fax:801-434-8704
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5736412-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife