Basic Information
| Provider Information | |||||||||
| NPI: | 1275786105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SORENSEN | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 CENTRAL AVE N | ||||||||
| Address2: | MEDICAL BUILDING STE 228 | ||||||||
| City: | WAYZATA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553911206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529938250 | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 CENTRAL AVE N BLDG STE 228 | ||||||||
| Address2: | |||||||||
| City: | WAYZATA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553911206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529938250 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 53198 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.