Healthcare Provider Details

I. General information

NPI: 1417276262
Provider Name (Legal Business Name): JENNIFER L. NORRIS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 PIONEER LN STE B
BISHOP CA
93514-2517
US

IV. Provider business mailing address

150 PIONEER LN
BISHOP CA
93514-2556
US

V. Phone/Fax

Practice location:
  • Phone: 760-873-2602
  • Fax:
Mailing address:
  • Phone: 760-873-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: