Individual
ERIC LEONARD SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
412 N 200 E, LOGAN, UT 84321-4038
(435) 713-2777
Mailing address
412 N 200 E, LOGAN, UT 84321-4038
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0024167553
VA
363LF0000X
Family Nurse Practitioner
Primary
5662905-4405
UT
363LF0000X
Family Nurse Practitioner
ARNP9308320
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002499500
—
FL
05
—
1497945091
—
VA
01
—
DQ733Z
MEDICARE PTAN
—
Enumeration date
07/30/2007
Last updated
11/03/2022
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