Provider Demographics
NPI:1417276262
Name:NORRIS, JENNIFER L (CNM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 PIONEER LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2517
Mailing Address - Country:US
Mailing Address - Phone:760-873-2602
Mailing Address - Fax:760-873-2750
Practice Address - Street 1:153 PIONEER LN
Practice Address - Street 2:SUITE C
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2517
Practice Address - Country:US
Practice Address - Phone:760-873-2602
Practice Address - Fax:760-873-2750
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1880367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife