Provider Demographics
NPI:1154657054
Name:SORENSEN, DARCIE K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DARCIE
Middle Name:K
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:DARCIE
Other - Middle Name:K
Other - Last Name:CRAVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2751 DEBARR RD STE 285
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6817
Mailing Address - Country:US
Mailing Address - Phone:907-243-0339
Mailing Address - Fax:
Practice Address - Street 1:2751 DEBARR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-243-0339
Practice Address - Fax:907-243-0337
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2041363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1570499Medicaid