Provider Demographics
NPI:1023398708
Name:SORENSEN, LINDSEY L
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:L
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 W APACHE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5527
Mailing Address - Country:US
Mailing Address - Phone:505-325-5358
Mailing Address - Fax:505-327-1482
Practice Address - Street 1:807 W APACHE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5527
Practice Address - Country:US
Practice Address - Phone:505-325-5358
Practice Address - Fax:505-327-1482
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator