Provider Demographics
NPI:1851704787
Name:SORRELLS, ASHTON (ARNP)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:SORRELLS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ASHTON
Other - Middle Name:
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:125 BAPTIST WAY STE 3A
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2274
Mailing Address - Country:US
Mailing Address - Phone:448-227-6604
Mailing Address - Fax:850-857-1747
Practice Address - Street 1:125 BAPTIST WAY STE 3A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2274
Practice Address - Country:US
Practice Address - Phone:448-227-6604
Practice Address - Fax:850-857-1747
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1125090363L00000X
FLARNP9374130363L00000X
FLARNP 9374130363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014399600Medicaid
FL014399600Medicaid
FLIA121Y - PASCOMedicare PIN