MEDICARE: HEATHER SORROW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN175512	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN175512	OTHER	GA	GEORGIA LICENSING NUMBER

General Provider Information

NPI Number	:	1821459074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER SORROW

Provider Business Mailing Address
First Line	:	334 MARGIE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-7817
Country	:	US
Telephone Number	:	478-988-0022
Fax Number	:	478-987-0444

Provider Business Practice Location Address
First Line	:	334 MARGIE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-7817
Country	:	US
Telephone Number	:	478-988-0022
Fax Number	:	478-987-0444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2016
Last Update Date	:	04/22/2026

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Directions to “ HEATHER SORROW ” Practice Location

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