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General NPI Number Information
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NPI Number | 1710930185
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Entity Type | Individual
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Provider Name | TANYA R. SORRELL PHD, NP
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 1645 W JACKSON BLVD STE 302
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City | CHICAGO
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State | IL
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Zip | 60612-3227
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Country | US
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Telephone | 928-304-3866
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Fax | 615-622-8760
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Provider Business Mailing Address
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Address Line | 3525 W OXFORD AVE
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City | DENVER
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State | CO
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Zip | 80236-3106
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Country | US
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Telephone | 303-315-6150
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Fax | 303-797-4266
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN124885
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0000100
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.021792
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP1834
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License Number State | AZ
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