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General NPI Number Information
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NPI Number | 1194401539
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Entity Type | Individual
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Provider Name | GINA SORRENTINO
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 20 SOUTH END COURT BLDG 9
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City | HAMPSTEAD
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State | NC
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Zip | 28443-7013
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Country | US
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Telephone | 910-270-3673
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Fax |
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Provider Business Mailing Address
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Address Line | 355 ARBORETUM DR APT 201
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City | WILMINGTON
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State | NC
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Zip | 28405-6283
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5018309
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License Number State | NC
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