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General NPI Number Information
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NPI Number | 1255972139
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Entity Type | Individual
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Provider Name | JESSICA THEO SORRICK NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 688 23 1/2 RD STE 301
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-8904
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Country | US
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Telephone | 970-644-4030
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Fax | 970-644-3914
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Provider Business Mailing Address
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Address Line | PO BOX 1727
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City | GRAND JUNCTION
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State | CO
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Zip | 81502-1727
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Country | US
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Telephone | 970-257-6200
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Fax | 970-263-2691
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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 | 2019024646
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0103458-C-NP
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License Number State | CO
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