Provider Demographics
NPI:1457619603
Name:SORENSON, JAMIE LEE (MD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:SORENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2606 CENTENNIAL PL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0572
Mailing Address - Country:US
Mailing Address - Phone:850-205-0189
Mailing Address - Fax:850-329-2903
Practice Address - Street 1:2606 CENTENNIAL PL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0572
Practice Address - Country:US
Practice Address - Phone:850-205-0189
Practice Address - Fax:850-329-2903
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN520912084P0800X, 2084P0800X
FLME1509312084P0800X
COCDRH.00572242084P0800X
GA865152084P0800X
NE323652084P0800X
IL0361518242084P0800X
ND163582084P0800X
MN668652084P0800X
KS04-429772084P0800X
IDMC-04022084P0800X
IAMD-470392084P0800X
SD119012084P0800X
CO572242084P0800X
WAMD610458262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO14538253Medicaid
CO36712523Medicaid
CO12561059OtherCAQH
CO550590YQKBMedicare PIN