Provider Demographics
NPI:1629621412
Name:SORENSEN, LINDSEY ANNE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANNE
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 1:5705 SOUTHERN CROSS DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5799
Mailing Address - Country:US
Mailing Address - Phone:972-965-1428
Mailing Address - Fax:
Practice Address - Street 1:5705 SOUTHERN CROSS DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-5799
Practice Address - Country:US
Practice Address - Phone:972-965-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142037363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner