Provider Demographics
NPI:1043601586
Name:SORRICK, LORRAINE (LPN)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:SORRICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10182 12TH WAY N APT 107
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-4363
Mailing Address - Country:US
Mailing Address - Phone:727-505-3981
Mailing Address - Fax:
Practice Address - Street 1:10182 12TH WAY N APT 107
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-4363
Practice Address - Country:US
Practice Address - Phone:727-505-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5183688164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse