Provider Demographics
NPI:1437624442
Name:NORVILLE, BLISS DAVIS (FNP)
Entity Type:Individual
Prefix:
First Name:BLISS
Middle Name:DAVIS
Last Name:NORVILLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 DEER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-2093
Mailing Address - Country:US
Mailing Address - Phone:252-503-5819
Mailing Address - Fax:
Practice Address - Street 1:388 VENTURE DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4775
Practice Address - Country:US
Practice Address - Phone:919-938-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF09181394363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily