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General NPI Number Information
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NPI Number | 1093251381
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Entity Type | Individual
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Provider Name | TIFFANY SORENSEN PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/11/2017
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 3640 MIDDLEBURY RD
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City | IOWA CITY
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State | IA
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Zip | 52245-2712
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Country | US
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Telephone | 319-467-6789
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Fax |
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Provider Business Mailing Address
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Address Line | 2978 WAGON WHEEL DR
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City | IOWA CITY
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State | IA
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Zip | 52240-9230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085657
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License Number State | IA
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