Provider Demographics
NPI:1033158449
Name:SORENSON, CAROLINE ERICA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:ERICA
Last Name:SORENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:ERICA
Other - Last Name:GOLOSOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:321 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-4032
Mailing Address - Country:US
Mailing Address - Phone:308-534-9100
Mailing Address - Fax:308-534-9112
Practice Address - Street 1:321 E 3RD ST STE 1
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4032
Practice Address - Country:US
Practice Address - Phone:308-534-9100
Practice Address - Fax:308-534-9112
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23650208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025398700Medicaid
NE00664OtherBLUE CROSS/BLUE SHIELD NE
NEP00332091OtherRAILROAD MEDICARE
NE251278OtherMIDLANDS CHOICE
NEI55301Medicare UPIN
NEP00332091OtherRAILROAD MEDICARE