Provider Demographics
NPI:1619346954
Name:NORRIS, DEANNA (BSM, CPM, LM)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:BSM, CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6693
Mailing Address - Country:US
Mailing Address - Phone:405-630-0606
Mailing Address - Fax:580-203-0923
Practice Address - Street 1:1801 E 15TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6693
Practice Address - Country:US
Practice Address - Phone:405-630-0606
Practice Address - Fax:580-203-0923
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKMIDW0014176B00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula