Provider Demographics
NPI:1215606959
Name:SORG, DEBRA JEAN (APRN)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:JEAN
Last Name:SORG
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:5800 LANDERBROOK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6510
Mailing Address - Country:US
Mailing Address - Phone:440-443-0423
Mailing Address - Fax:440-443-0414
Practice Address - Street 1:4350 CROCKER RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6329
Practice Address - Country:US
Practice Address - Phone:440-588-8005
Practice Address - Fax:440-835-4790
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029461363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily