Provider Demographics
NPI:1124827597
Name:SORENSEN WILLIAMS, AMY JO
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:SORENSEN WILLIAMS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JO
Other - Last Name:SORENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1280 E CALVADA BLVD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5693
Mailing Address - Country:US
Mailing Address - Phone:775-910-9811
Mailing Address - Fax:775-548-3225
Practice Address - Street 1:1280 E CALVADA BLVD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5693
Practice Address - Country:US
Practice Address - Phone:775-910-9811
Practice Address - Fax:775-548-3225
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily