Provider Demographics
NPI:1023715398
Name:NORRIS, CARLA COX (NP)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:COX
Last Name:NORRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3188 DUSTY RD
Mailing Address - Street 2:
Mailing Address - City:LORIS
Mailing Address - State:SC
Mailing Address - Zip Code:29569-6706
Mailing Address - Country:US
Mailing Address - Phone:843-907-3370
Mailing Address - Fax:
Practice Address - Street 1:2828 BAYBORO ST
Practice Address - Street 2:
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-2710
Practice Address - Country:US
Practice Address - Phone:843-716-2229
Practice Address - Fax:843-716-2483
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27138363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner