Provider Demographics
NPI:1255771754
Name:NORRIS, ALICE MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:MARIE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:MARIE
Other - Last Name:RUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7700 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4113
Mailing Address - Country:US
Mailing Address - Phone:954-939-7656
Mailing Address - Fax:
Practice Address - Street 1:701 6TH AVE SOUTH
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4509
Practice Address - Country:US
Practice Address - Phone:727-823-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9210034367500000X
FLAPRN9210034367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103782700Medicaid