Provider Demographics
NPI:1588002802
Name:NORRIS, KELLY K (CRNA)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:K
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:3835 S JONES BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-7125
Mailing Address - Country:US
Mailing Address - Phone:702-880-4193
Mailing Address - Fax:702-880-4197
Practice Address - Street 1:3835 S JONES BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-7125
Practice Address - Country:US
Practice Address - Phone:702-880-4193
Practice Address - Fax:702-880-4197
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-08
Last Update Date:2019-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP136191367500000X
NVCRNA000424367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered