Individual
BETHANIE B. SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10815 W MCDOWELL RD STE 202, AVONDALE, AZ 85392-5010
(623) 433-0202
(623) 433-0204
Mailing address
3815 E BELL RD STE 4500, PHOENIX, AZ 85032-2171
(602) 633-3838
(602) 633-3845
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2906
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
832693
—
AZ
01
—
Z145996
MEDICARE
—
Enumeration date
08/12/2005
Last updated
07/31/2024
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