Provider Demographics
NPI:1740584986
Name:NORRIS, WADNA LEE
Entity Type:Individual
Prefix:MS
First Name:WADNA
Middle Name:LEE
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 1:4175 S ALAMO AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-4402
Mailing Address - Country:US
Mailing Address - Phone:520-228-2877
Mailing Address - Fax:520-228-2674
Practice Address - Street 1:4175 S ALAMO AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85707-4402
Practice Address - Country:US
Practice Address - Phone:520-228-2877
Practice Address - Fax:520-228-2674
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291900000XLaboratoriesMilitary Clinical Medical Laboratory