Healthcare Provider Details

I. General information

NPI: 1063708261
Provider Name (Legal Business Name): DAVENA MARIE NORRIS PHARMD, RPH, PHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2011
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S MAIN ST
LAS CRUCES NM
88001-1266
US

IV. Provider business mailing address

612 W. HADLEY AVE
LAS CRUCES NM
88005-5141
US

V. Phone/Fax

Practice location:
  • Phone: 575-201-3353
  • Fax: 800-547-1934
Mailing address:
  • Phone: 575-636-7326
  • Fax: 575-521-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00007834
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPC00000237
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberIN00003099
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: