Individual
CARRIE M SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 SIXTH ST STE 200, TRAVERSE CITY, MI 49684-2369
(231) 935-5800
(231) 935-5799
Mailing address
2891 MOMENTUM PL, CHICAGO, IL 60689-5328
(231) 935-6080
(231) 935-6081
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60051685
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601006801
MI LICENSE
MI
Enumeration date
11/05/2008
Last updated
07/21/2022
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