Provider Demographics
NPI:1235603572
Name:NORRIS, TANA PATRICIA
Entity Type:Individual
Prefix:
First Name:TANA
Middle Name:PATRICIA
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 WOLFLIN AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2141
Mailing Address - Country:US
Mailing Address - Phone:806-517-5452
Mailing Address - Fax:
Practice Address - Street 1:6801 WOLFLIN AVE APT 205
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2141
Practice Address - Country:US
Practice Address - Phone:806-517-5452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314041164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse