Provider Demographics
NPI:1811760572
Name:NORRIS, OLIVIA ROSE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ROSE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:ROSE
Other - Last Name:ROCHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 N COMAL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3505
Mailing Address - Country:US
Mailing Address - Phone:210-335-6260
Mailing Address - Fax:
Practice Address - Street 1:200 N COMAL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3505
Practice Address - Country:US
Practice Address - Phone:210-335-6260
Practice Address - Fax:210-338-6193
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1113074363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner