Provider Demographics
NPI:1528933124
Name:NORRIS, MARY ELIZABETH (LDO)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LDO
Mailing Address - Street 1:116 MAINLINE STATION DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6825
Mailing Address - Country:US
Mailing Address - Phone:919-605-4621
Mailing Address - Fax:
Practice Address - Street 1:5826 FAYETTEVILLE RD
Practice Address - Street 2:STE 104
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-405-2888
Practice Address - Fax:919-405-2889
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1813156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician