Provider Demographics
NPI:1811582836
Name:SABIN, ALLISON JENSEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:JENSEN
Last Name:SABIN
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 1:4102 QUAIL RUN
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-5204
Mailing Address - Country:US
Mailing Address - Phone:316-518-5066
Mailing Address - Fax:
Practice Address - Street 1:1244 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-9839
Practice Address - Country:US
Practice Address - Phone:435-882-3968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT119789631206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant