Provider Demographics
NPI:1710073770
Name:CERVI, NORINE A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NORINE
Middle Name:A
Last Name:CERVI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 BLOOMSBURY RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-9603
Mailing Address - Country:US
Mailing Address - Phone:252-917-4227
Mailing Address - Fax:252-689-4315
Practice Address - Street 1:2460 EMERALD PL
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5784
Practice Address - Country:US
Practice Address - Phone:252-830-2021
Practice Address - Fax:252-830-2042
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200648363LA2200X, 363LC0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P12897Medicare UPIN
NC2599238Medicare ID - Type Unspecified