Provider Demographics
NPI:1689903403
Name:HOWARD, SARINA ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARINA
Middle Name:ROSE
Last Name:HOWARD
Suffix:
Gender:F
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 1:841 S SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-9678
Mailing Address - Country:US
Mailing Address - Phone:760-533-8229
Mailing Address - Fax:
Practice Address - Street 1:1188 W SPORTSPLEX DR STE 105
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-6817
Practice Address - Country:US
Practice Address - Phone:760-533-8229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 16414363A00000X
WAPA 10003765363A00000X
IDPA 752363A00000X
UT347101-8906363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDPA-752OtherMEDICAL LICENSE
IDCS13139OtherPHARMACY
CAPA 16414OtherMEDICAL LICENSE
WAPA 10003765OtherMEDICAL LICENSE
WAPA 10003765OtherMEDICAL LICENSE