Individual
MRS. MARY JANE WILD SORENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5300 S SUTTER DR STE A, SHOW LOW, AZ 85901-8054
(928) 251-4244
Mailing address
1857 N SPRINGER MOUNTAIN DR, LAKESIDE, AZ 85929-6617
(520) 730-3074
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP11648
AZ
Other
Enumeration date
08/09/2018
Last updated
02/07/2024
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