Provider Demographics
NPI:1164755732
Name:SORENSEN, ROBYN R (RPH)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:R
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SECOND AVE NW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3152
Mailing Address - Country:US
Mailing Address - Phone:701-663-1151
Mailing Address - Fax:701-663-4514
Practice Address - Street 1:116 SECOND AVE NW
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-3152
Practice Address - Country:US
Practice Address - Phone:701-663-1151
Practice Address - Fax:701-663-4514
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist