Healthcare Provider Details

I. General information

NPI: 1871924316
Provider Name (Legal Business Name): ASHLEY JORDAN NORRIS CRNA, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MAST RD APT 3
LEE NH
03861-6570
US

IV. Provider business mailing address

7 TOON LN
LEE NH
03861-6506
US

V. Phone/Fax

Practice location:
  • Phone: 802-989-2666
  • Fax: 802-277-7321
Mailing address:
  • Phone: 802-989-2666
  • Fax: 802-277-7321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number06082123
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number6082123
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: