Provider Demographics
NPI:1871512483
Name:NORRIS, PATRICIA JANE (APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JANE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 LAKE RD
Mailing Address - Street 2:APT # 1
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-5711
Mailing Address - Country:US
Mailing Address - Phone:936-668-6494
Mailing Address - Fax:
Practice Address - Street 1:2501 LAKE RD APT 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-5736
Practice Address - Country:US
Practice Address - Phone:936-668-6494
Practice Address - Fax:936-230-5353
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121554363LG0600X
GARN133089363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00230873OtherRAILROAD RETIREMENT
TXT0188917OtherDPS
TXT0188917OtherDPS
GAS62853Medicare UPIN
TX285761YRW3Medicare PIN
GAP00230873OtherRAILROAD RETIREMENT
TXMN2640274OtherDEA