Provider Demographics
NPI:1073937330
Name:SORUNKE, URSULA
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:
Last Name:SORUNKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 RED CLAY RD APT 301
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2323
Mailing Address - Country:US
Mailing Address - Phone:301-500-4250
Mailing Address - Fax:
Practice Address - Street 1:271 RED CLAY RD APT 301
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2323
Practice Address - Country:US
Practice Address - Phone:301-500-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10184374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide