Healthcare Provider Details

I. General information

NPI: 1891249009
Provider Name (Legal Business Name): KATHERINE NORRICK MSN-FNP, PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 07/02/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 HIGHWAY 61 S. SUITE N1000
FESTUS MO
63028-4136
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 636-933-9300
  • Fax: 636-933-9114
Mailing address:
  • Phone: 636-933-9300
  • Fax: 636-933-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023021237
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2016027657
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: