Provider Demographics
NPI:1649865668
Name:SORENSON, LORI ANN (MS)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:SORENSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50692 WYMER LAKE LOOP
Mailing Address - Street 2:
Mailing Address - City:FRAZEE
Mailing Address - State:MN
Mailing Address - Zip Code:56544-8984
Mailing Address - Country:US
Mailing Address - Phone:218-850-8030
Mailing Address - Fax:
Practice Address - Street 1:50692 WYMER LAKE LOOP
Practice Address - Street 2:
Practice Address - City:FRAZEE
Practice Address - State:MN
Practice Address - Zip Code:56544-8984
Practice Address - Country:US
Practice Address - Phone:218-850-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide