Provider Demographics
NPI:1740774728
Name:SORENSEN, LUCINDA ANN (RN)
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:ANN
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LUCINDA
Other - Middle Name:ANN
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5001 W DOBBINS RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-9733
Mailing Address - Country:US
Mailing Address - Phone:602-761-8919
Mailing Address - Fax:
Practice Address - Street 1:5001 W DOBBINS RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-9733
Practice Address - Country:US
Practice Address - Phone:602-761-8919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN167314163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool