Healthcare Provider Details

I. General information

NPI: 1427356971
Provider Name (Legal Business Name): ANNA C NORRIS PNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 12/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 EAST BLVD., SUITE 280
CHARLOTTE NC
28203-5793
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1866
  • Fax: 704-384-1867
Mailing address:
  • Phone: 704-384-1866
  • Fax: 704-384-1867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number210662
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5005093
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: