Provider Demographics
NPI:1740397249
Name:NORRIS, ANGELA J (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4232 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4011
Mailing Address - Country:US
Mailing Address - Phone:215-287-4685
Mailing Address - Fax:
Practice Address - Street 1:1233 LOCUST ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5453
Practice Address - Country:US
Practice Address - Phone:267-725-0252
Practice Address - Fax:215-732-1046
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009102363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner