Healthcare Provider Details

I. General information

NPI: 1790613685
Provider Name (Legal Business Name): JENNA NORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7755 OFFICE PLAZA DR N STE 105
WEST DES MOINES IA
50266-2339
US

IV. Provider business mailing address

6030 CRESTON AVE UNIT 47
DES MOINES IA
50321-1256
US

V. Phone/Fax

Practice location:
  • Phone: 515-505-7283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: