Provider Demographics
NPI:1205304573
Name:SORENSON, LYNN MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:SORENSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:THERENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:235 E SHEFFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-4050
Mailing Address - Country:US
Mailing Address - Phone:480-435-0968
Mailing Address - Fax:
Practice Address - Street 1:2002 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7236
Practice Address - Country:US
Practice Address - Phone:602-730-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN089517163W00000X
AZ224984363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse