Individual
STACY MARIE SORENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14 MAIN AVE S, BAGLEY, MN 56621-8158
(218) 694-3444
(218) 694-3443
Mailing address
PO BOX 901, 14 SOUTH MAIN AVE, BAGLEY, MN 56621-0901
(218) 694-3444
(218) 694-3443
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-207726-4
MN
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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