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NPI Code Detail

MEDICARE: AVA CAMILLE SORENSEN

MEDICARE: AVA CAMILLE SORENSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1831046556
Entity Type Code : Individual
Provider Name (Legal Business Name) : AVA CAMILLE SORENSEN
Provider Business Mailing Address
First Line : 7206 S COLUMBIA PL
Second Line :
City : TULSA
State : OK
Zip : 74136-5656
Country : US
Telephone Number : 918-605-6857
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W 17TH ST
Second Line :
City : TULSA
State : OK
Zip : 74107-1886
Country : US
Telephone Number : 918-582-1972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “ AVA CAMILLE SORENSEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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