Provider Demographics
NPI:1780319418
Name:NORRIS, BEVERLY PAIGE
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:PAIGE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 KARRINGTON RDG APT F
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-8898
Mailing Address - Country:US
Mailing Address - Phone:479-799-7655
Mailing Address - Fax:
Practice Address - Street 1:2009 KARRINGTON RDG APT F
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-8898
Practice Address - Country:US
Practice Address - Phone:479-799-7655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR089858163W00000X
AR225418367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse