Provider Demographics
NPI:1013724095
Name:NORRIS, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
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 1:157 S LIBERTY KEUTER RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9333
Mailing Address - Country:US
Mailing Address - Phone:513-575-6547
Mailing Address - Fax:
Practice Address - Street 1:157 S LIBERTY KEUTER RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9333
Practice Address - Country:US
Practice Address - Phone:513-575-6547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant