Provider Demographics
NPI:1508404831
Name:NORSWORTHY, DARRAH AMANDA (NP)
Entity Type:Individual
Prefix:
First Name:DARRAH
Middle Name:AMANDA
Last Name:NORSWORTHY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BRYANT CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5621
Mailing Address - Country:US
Mailing Address - Phone:228-327-3622
Mailing Address - Fax:
Practice Address - Street 1:4211 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5320
Practice Address - Country:US
Practice Address - Phone:228-497-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903313363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily