MEDICARE: MRS. HELEN MARIE NORRIS NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71001913A	IN
2	363LA2200X	Adult Health Nurse Practitioner	71001913A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01435394	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000872516	OTHER	IN	BCBS NORTH CENTRAL CARDIOVASCULAR

General Provider Information

NPI Number	:	1164463238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HELEN MARIE NORRIS NP-C

Provider Business Mailing Address
First Line	:	710 N NILES AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-1924
Country	:	US
Telephone Number	:	574-647-1610
Fax Number	:

Provider Business Practice Location Address
First Line	:	4630 VISTULA RD
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46544-4000
Country	:	US
Telephone Number	:	574-318-4291
Fax Number	:	574-318-4759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	04/28/2023

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Directions to “ MRS. HELEN MARIE NORRIS NP-C” Practice Location

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