Provider Demographics
NPI:1679710693
Name:SORENSEN, APRIL AUSTINA (RD, LN)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:AUSTINA
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:RD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 OAK ST.
Mailing Address - Street 2:PO BOX 100
Mailing Address - City:FAULKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57438-0100
Mailing Address - Country:US
Mailing Address - Phone:605-598-6262
Mailing Address - Fax:605-598-4199
Practice Address - Street 1:1300 OAK ST.
Practice Address - Street 2:
Practice Address - City:FAULKTON
Practice Address - State:SD
Practice Address - Zip Code:57438-0100
Practice Address - Country:US
Practice Address - Phone:605-598-6262
Practice Address - Fax:605-598-4199
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD00896139133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered