Provider Demographics
NPI:1780276956
Name:NORRIS, HAYLEY MADISON (PA-C)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MADISON
Last Name:NORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:MADISON
Other - Last Name:COTTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:210 FORGE RD STE 2
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:17007-9787
Practice Address - Country:US
Practice Address - Phone:717-254-6109
Practice Address - Fax:717-701-8522
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
PAMA062561363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1S9361OtherMEDICARE
PA1039169000001Medicaid