Provider Demographics
NPI:1750907077
Name:NORRIS, GRACE B (APRN)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:B
Last Name:NORRIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 N DILLARD ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2817
Mailing Address - Country:US
Mailing Address - Phone:407-877-8080
Mailing Address - Fax:407-877-0907
Practice Address - Street 1:436 N DILLARD ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2817
Practice Address - Country:US
Practice Address - Phone:407-877-8080
Practice Address - Fax:407-877-0907
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006037363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty