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NPI Code Detail

MEDICARE: TARA NORRIS APN

MEDICARE: TARA NORRIS APN
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerA03653AR

General Provider Information

NPI Number : 1942574645
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA NORRIS APN
Provider Business Mailing Address
First Line : 4704 CHESTNUT WAY
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-2312
Country : US
Telephone Number : 479-883-8059
Fax Number :
Provider Business Practice Location Address
First Line : 7217 CAMERON PARK DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6167
Country : US
Telephone Number : 479-831-6007
Fax Number : 479-782-1242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2012
Last Update Date : 10/09/2019

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Directions to “ TARA NORRIS APN” Practice Location

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