Provider Demographics
NPI:1831398981
Name:NORRIS, TIFFANY MARIE (PMHNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 HOSPITAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6913
Mailing Address - Country:US
Mailing Address - Phone:817-849-2708
Mailing Address - Fax:817-848-4579
Practice Address - Street 1:1600 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6913
Practice Address - Country:US
Practice Address - Phone:817-849-2708
Practice Address - Fax:817-848-4579
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX617631163WP0808X, 363LP0808X
TXAP109391363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3082OtherBLUE CROSS BLUE SHIELD
TX8K5708Medicare PIN