Provider Demographics
NPI:1770893562
Name:NORRIS, KRISTI (NMD)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E MARCO POLO RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1023
Mailing Address - Country:US
Mailing Address - Phone:602-550-7949
Mailing Address - Fax:602-234-9691
Practice Address - Street 1:550 W INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 122
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3212
Practice Address - Country:US
Practice Address - Phone:602-550-7949
Practice Address - Fax:602-234-9691
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101217175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath