Healthcare Provider Details

I. General information

NPI: 1245528900
Provider Name (Legal Business Name): SARAH SORRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W 22ND ST
SIOUX FALLS SD
57105-1508
US

IV. Provider business mailing address

1508 W 22ND ST
SIOUX FALLS SD
57105-1508
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-1000
  • Fax:
Mailing address:
  • Phone: 605-333-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCP000645
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCP000645
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: