Individual
JENNIFER SORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6285 S HIGLEY RD, GILBERT, AZ 85298-4262
(480) 460-4949
(480) 460-5858
Mailing address
6285 S HIGLEY RD, GILBERT, AZ 85298-4262
(480) 460-4949
(480) 460-5858
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28193085A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
248632
STATE LICENSE
AZ
01
—
28193085A
LICENSE
IN
Enumeration date
04/30/2014
Last updated
11/30/2020
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