Provider Demographics
NPI:1124777453
Name:SORRELS, MORGAN DANAE (PA-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:DANAE
Last Name:SORRELS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107 GLIDEPATH WAY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-4133
Mailing Address - Country:US
Mailing Address - Phone:615-449-5771
Mailing Address - Fax:615-449-5740
Practice Address - Street 1:3786 CENTRAL PIKE STE 110
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3498
Practice Address - Country:US
Practice Address - Phone:615-964-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN5074363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant