Healthcare Provider Details

I. General information

NPI: 1649804964
Provider Name (Legal Business Name): MARCI SORRELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 E 8680 S
SANDY UT
84070-1645
US

IV. Provider business mailing address

329 E 8680 S
SANDY UT
84070-1645
US

V. Phone/Fax

Practice location:
  • Phone: 801-808-0153
  • Fax:
Mailing address:
  • Phone: 801-808-0153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: