Provider Demographics
NPI:1245752740
Name:EVANS, TRISHA D (APRN)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:D
Last Name:EVANS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:49 S SAMARA ST
Mailing Address - Street 2:
Mailing Address - City:VINEYARD
Mailing Address - State:UT
Mailing Address - Zip Code:84059-6540
Mailing Address - Country:US
Mailing Address - Phone:925-918-1354
Mailing Address - Fax:801-810-1018
Practice Address - Street 1:49 S SAMARA ST
Practice Address - Street 2:
Practice Address - City:VINEYARD
Practice Address - State:UT
Practice Address - Zip Code:84059-6540
Practice Address - Country:US
Practice Address - Phone:925-918-1354
Practice Address - Fax:801-810-1018
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7523116-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner