Provider Demographics
NPI:1558336792
Name:SORELLE, NORMA FAITH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:FAITH
Last Name:SORELLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 MORENO CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6312
Mailing Address - Country:US
Mailing Address - Phone:775-375-5745
Mailing Address - Fax:702-998-6977
Practice Address - Street 1:3524 MORENO CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6312
Practice Address - Country:US
Practice Address - Phone:775-375-5745
Practice Address - Fax:702-998-6977
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV000342367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVDG617ZMedicare PIN
MANA0051OtherBLUE CROSS OF MA