Provider Demographics
NPI:1841284510
Name:NORRIS, CAROL A (CRNA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 HOMER AVE
Mailing Address - Street 2:POB 628
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-0628
Mailing Address - Country:US
Mailing Address - Phone:607-758-3752
Mailing Address - Fax:607-758-3754
Practice Address - Street 1:134 HOMER AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1206
Practice Address - Country:US
Practice Address - Phone:607-753-7263
Practice Address - Fax:607-753-7264
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165495367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
R86445Medicare UPIN
NYDD4503Medicare PIN