Provider Demographics
NPI:1649004078
Name:NORRIS, CARLA ANN (RN)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ANN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45634-0102
Mailing Address - Country:US
Mailing Address - Phone:614-743-1068
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 102
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45634-0102
Practice Address - Country:US
Practice Address - Phone:614-743-1068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN460375163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology