Provider Demographics
NPI:1063251882
Name:SORENSEN, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KACIE LN
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03826-8219
Mailing Address - Country:US
Mailing Address - Phone:603-819-6948
Mailing Address - Fax:
Practice Address - Street 1:716 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2693
Practice Address - Country:US
Practice Address - Phone:207-283-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant