Provider Demographics
NPI:1730389297
Name:TWELVES, TRICIA ANNE (MD)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANNE
Last Name:TWELVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12391 S 4000 W
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-7012
Mailing Address - Country:US
Mailing Address - Phone:801-302-1750
Mailing Address - Fax:801-302-1715
Practice Address - Street 1:12391 S 4000 W
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-7012
Practice Address - Country:US
Practice Address - Phone:801-302-1750
Practice Address - Fax:801-302-1715
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116016847207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology