Provider Demographics
NPI:1720047327
Name:SORRENTINO, DEBORAH ANN (APRN-BC ( FNP))
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:APRN-BC ( FNP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 VIRGINIA RD
Mailing Address - Street 2:UNIT 410
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-1100
Mailing Address - Country:US
Mailing Address - Phone:781-538-6525
Mailing Address - Fax:
Practice Address - Street 1:1 ASHBURTON PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-1518
Practice Address - Country:US
Practice Address - Phone:617-355-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily