Provider Demographics
NPI:1740621655
Name:SORRENTINO, NATALIE M (BSN, RN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 29 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5383
Mailing Address - Country:US
Mailing Address - Phone:970-248-6940
Mailing Address - Fax:970-255-3654
Practice Address - Street 1:510 29 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5383
Practice Address - Country:US
Practice Address - Phone:970-248-6940
Practice Address - Fax:970-255-3654
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0179864163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse