Healthcare Provider Details

I. General information

NPI: 1821459074
Provider Name (Legal Business Name): HEATHER SORROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 MARGIE DR
WARNER ROBINS GA
31088-7817
US

IV. Provider business mailing address

334 MARGIE DR
WARNER ROBINS GA
31088-7817
US

V. Phone/Fax

Practice location:
  • Phone: 478-988-0022
  • Fax: 478-987-0444
Mailing address:
  • Phone: 478-988-0022
  • Fax: 478-987-0444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN175512
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: