Healthcare Provider Details
I. General information
NPI: 1386903425
Provider Name (Legal Business Name): MICHELLE ANGELA NORRIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/10/2012
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 N WEST AVE
JACKSON MI
49202-2179
US
IV. Provider business mailing address
308 TURTLE CV
PANAMA CITY BEACH FL
32413-8441
US
V. Phone/Fax
- Phone: 517-789-1200
- Fax:
- Phone: 423-505-7042
- Fax: 850-688-9004
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | APRN9434194 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | ARNP9434194 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 4704411492 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | APRN9434194 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: