Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ||
Y | 176B00000X | Midwife | 8858598-3400 | UT |
NPI | 1366680761 |
---|---|
Provider Name | Vickie D Sorensen |
First Address | Cedar City, UT 84720-1800 |
Second Address | Cedar City, UT 84720-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2009 |
Last Update Date | 04/02/2014 |