| NPI | 1174978845 |
|---|---|
| Former Name | JESSICA MICHELLE SORENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8282806-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 8282806-3102) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2020-07-28 |