Provider Demographics
NPI:1366917270
Name:APPLE, TREVOR (PA-C)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:APPLE
Suffix:
Gender:M
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 1:11432 S LOGANBERRY CT
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9477
Mailing Address - Country:US
Mailing Address - Phone:435-773-5334
Mailing Address - Fax:
Practice Address - Street 1:11432 S LOGANBERRY CT
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9477
Practice Address - Country:US
Practice Address - Phone:435-773-5334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant