Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 8658 | NV |
NPI | 1003889098 |
---|---|
Provider Name | Susan E. Chambers-Sorensen |
First Address | Reno, NV 89502-1011 |
Second Address | Reno, NV 89502-1464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H20187 | (02) | NV |