Provider Demographics
NPI:1851799647
Name:NORRIS, KOLE MAXWELL (PA)
Entity Type:Individual
Prefix:
First Name:KOLE
Middle Name:MAXWELL
Last Name:NORRIS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:WHITE 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-724-4100
Mailing Address - Fax:617-726-7415
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WHITE 1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-4100
Practice Address - Fax:617-726-7415
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2024-04-25
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant