Provider Demographics
NPI:1497970495
Name:SORRELL, JUDITH E (ARNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:SORRELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:E
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2212
Mailing Address - Country:US
Mailing Address - Phone:404-686-4411
Mailing Address - Fax:
Practice Address - Street 1:601 E ROLLINS STREET
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-7283
Practice Address - Fax:321-843-5550
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN299767363LA2200X
FL1690512363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001005300Medicaid
FLAD438XMedicare PIN
FL001005300Medicaid
FLAD438YMedicare PIN