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General NPI Number Information
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NPI Number | 1427913011
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Entity Type | Individual
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Provider Name | JONI RAE SORRELS CCHW
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 4710 JEFFERSON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2155
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Country | US
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Telephone | 406-200-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 OSUNA RD NE APT 237
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-7236
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Country | US
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Telephone | 406-200-3001
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | G-1937
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License Number State | NM
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