Provider Demographics
NPI:1952034548
Name:NORVELL, ERIN ROSE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE
Last Name:NORVELL
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 1:9037 E 117TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-1806
Mailing Address - Country:US
Mailing Address - Phone:918-805-4779
Mailing Address - Fax:
Practice Address - Street 1:7106 E 151ST ST S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-4137
Practice Address - Country:US
Practice Address - Phone:918-805-4779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator