Provider Demographics
NPI:1558087064
Name:NORRIS, AUTUMN L
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:L
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 1:902 KEEN ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-3321
Mailing Address - Country:US
Mailing Address - Phone:740-252-6882
Mailing Address - Fax:
Practice Address - Street 1:902 KEEN ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-3321
Practice Address - Country:US
Practice Address - Phone:740-252-6882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide