Provider Demographics
NPI:1730135799
Name:SORRELLS, CHRISTI RENEE (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTI
Middle Name:RENEE
Last Name:SORRELLS
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 1:4016 BATTLEGROUND AVE STE H
Mailing Address - Street 2:#297
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9800
Mailing Address - Country:US
Mailing Address - Phone:336-312-9195
Mailing Address - Fax:
Practice Address - Street 1:2006 LIMESTONE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5553
Practice Address - Country:US
Practice Address - Phone:302-995-6891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0035397367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8051336Medicaid
DE017749O50OtherTRAILBLAZER MEDICARE
P00242367OtherRAILROAD MEDICARE
2618110CMedicare PIN