Provider Demographics
NPI:1891958708
Name:SORENSEN, KRISTEN A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:A
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W. LEUDA ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104
Mailing Address - Country:US
Mailing Address - Phone:817-926-2511
Mailing Address - Fax:817-924-0167
Practice Address - Street 1:6221 COLLEYVILLE BLVD, SUITE 150
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034
Practice Address - Country:US
Practice Address - Phone:817-251-6533
Practice Address - Fax:817-251-0340
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX749170364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health