Healthcare Provider Details

I. General information

NPI: 1235146937
Provider Name (Legal Business Name): KARA ALEXANDER-AGRESTA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA ALEXANDER PA-C

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5171 S COTTONWOOD ST
MURRAY UT
84107-5704
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-4000
  • Fax:
Mailing address:
  • Phone: 801-698-0991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number60245451206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: