Provider Demographics
NPI:1447373451
Name:NAY, TRENAISA (APRN-BC,NP)
Entity type:Individual
Prefix:MRS
First Name:TRENAISA
Middle Name:
Last Name:NAY
Suffix:
Gender:F
Credentials:APRN-BC,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 E 4800 S
Mailing Address - Street 2:STE 230
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5535
Mailing Address - Country:US
Mailing Address - Phone:801-391-4585
Mailing Address - Fax:801-282-0313
Practice Address - Street 1:306 RIVER BEND LN
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-5625
Practice Address - Country:US
Practice Address - Phone:801-226-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT200842-4405363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT200842-4405OtherSTATE LICENSE
UT1487761615Medicare ID - Type UnspecifiedNURSE PRACTITIONER GERONT