Provider Demographics
NPI:1730659616
Name:NORRIS, MEGAN D
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:D
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247036
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-7036
Mailing Address - Country:US
Mailing Address - Phone:402-955-5421
Mailing Address - Fax:402-955-6850
Practice Address - Street 1:110 N 175TH ST STE 1000
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3581
Practice Address - Country:US
Practice Address - Phone:402-955-8300
Practice Address - Fax:402-955-7310
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2273363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant