Provider Demographics
NPI:1558572560
Name:NORELLI, CHRISTOPHER RICHARD (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RICHARD
Last Name:NORELLI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-8557
Mailing Address - Country:US
Mailing Address - Phone:254-213-3763
Mailing Address - Fax:
Practice Address - Street 1:2002 FIELDSTONE DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-8557
Practice Address - Country:US
Practice Address - Phone:254-213-3763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant