Provider Demographics
NPI:1659336980
Name:NORRIS, KAREN M (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:NORRIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 NW 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:ST JOHN
Mailing Address - State:KS
Mailing Address - Zip Code:67576-8696
Mailing Address - Country:US
Mailing Address - Phone:620-792-9941
Mailing Address - Fax:
Practice Address - Street 1:1247 NW 30TH AVE
Practice Address - Street 2:
Practice Address - City:ST JOHN
Practice Address - State:KS
Practice Address - Zip Code:67576-8696
Practice Address - Country:US
Practice Address - Phone:620-792-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44371363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS044845OtherBLUE CROSS INDIV PROV NO
KS200269390AMedicaid