Healthcare Provider Details

I. General information

NPI: 1831398981
Provider Name (Legal Business Name): TIFFANY MARIE NORRIS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL PKWY
BEDFORD TX
76022-6913
US

IV. Provider business mailing address

1600 HOSPITAL PKWY
BEDFORD TX
76022-6913
US

V. Phone/Fax

Practice location:
  • Phone: 817-849-2708
  • Fax: 817-848-4579
Mailing address:
  • Phone: 817-849-2708
  • Fax: 817-848-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number617631
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number617631
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP109391
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: