Provider Demographics
NPI:1134180532
Name:HARRIS, NORVA ELAINE OSBORNE (OD)
Entity type:Individual
Prefix:
First Name:NORVA
Middle Name:ELAINE OSBORNE
Last Name:HARRIS
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:N.
Other - Middle Name:ELAINE
Other - Last Name:OSBORNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4949 PROFESSIONAL PARK DR STE 202
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-8638
Practice Address - Country:US
Practice Address - Phone:704-938-9777
Practice Address - Fax:704-938-9773
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1720152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89093AJMedicaid
NC1987910OtherUNITED HEALTHCARE
NC093AJOtherBCBS
NC093AJOtherBCBS
NC89093AJMedicaid
NC2471755AMedicare PIN
NC2471755Medicare PIN