Provider Demographics
NPI:1407233729
Name:NORRIS, TRACY (MS)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 E CEDAR AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-1957
Mailing Address - Country:US
Mailing Address - Phone:928-779-1679
Mailing Address - Fax:
Practice Address - Street 1:2224 E CEDAR AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1957
Practice Address - Country:US
Practice Address - Phone:928-779-1679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator