Provider Demographics
NPI:1649892332
Name:NORBURY, BRIAN W (APN)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:W
Last Name:NORBURY
Suffix:
Gender:M
Credentials:APN
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 125
Mailing Address - Street 2:
Mailing Address - City:WETMORE
Mailing Address - State:CO
Mailing Address - Zip Code:81253-0125
Mailing Address - Country:US
Mailing Address - Phone:719-568-0064
Mailing Address - Fax:
Practice Address - Street 1:1338 PHAY AVE BLDG D
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2326
Practice Address - Country:US
Practice Address - Phone:719-285-2700
Practice Address - Fax:719-285-2975
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995466-NP363LF0000X
COAPN0995466-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily