Provider Demographics
NPI:1366515348
Name:SORENSON, ROBERT (RN)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SORENSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LOTHROP ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4450
Mailing Address - Country:US
Mailing Address - Phone:207-783-4275
Mailing Address - Fax:207-283-1240
Practice Address - Street 1:333 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3113
Practice Address - Country:US
Practice Address - Phone:207-282-1500
Practice Address - Fax:207-283-1240
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERO37310163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health