Provider Demographics
NPI:1821877713
Name:SORENSEN, MEAGAN (FNP)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NICOLLET MALL STE 556
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2603
Mailing Address - Country:US
Mailing Address - Phone:844-670-2273
Mailing Address - Fax:833-471-4119
Practice Address - Street 1:825 NICOLLET MALL STE 556
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2603
Practice Address - Country:US
Practice Address - Phone:844-670-2273
Practice Address - Fax:833-471-4119
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR43760207Q00000X
MN10777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine