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NPI Code Detail

MEDICARE: MR. CHRISTOPHER RYAN SORRELL NP

MEDICARE: MR. CHRISTOPHER RYAN SORRELL NP
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
1363L00000XNurse PractitionerARNP9339943FL
2363LF0000XFamily Nurse PractitionerAPRN9339943FL
3363LA2100XAcute Care Nurse Practitioner71018254AIN
4363L00000XNurse Practitioner95014501CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2A3F6ZOTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972020410
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER RYAN SORRELL NP
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 705 RILEY HOSPITAL DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-5109
Country : US
Telephone Number : 317-274-4491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2017
Last Update Date : 06/24/2026

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