Provider Demographics
NPI:1598815185
Name:SORGEN, JEANNIE MARGURITE (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNIE
Middle Name:MARGURITE
Last Name:SORGEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 WOODS PL BLDG 2
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7991
Mailing Address - Country:US
Mailing Address - Phone:325-691-0030
Mailing Address - Fax:
Practice Address - Street 1:4225 WOODS PL BLDG 2
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7991
Practice Address - Country:US
Practice Address - Phone:325-691-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584021363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L2450Medicare PIN