Healthcare Provider Details

I. General information

NPI: 1053580233
Provider Name (Legal Business Name): LAURA ANN NORRIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 S COLLEGE AVE SUITE 101
COLLEGE PLACE WA
99324-1193
US

IV. Provider business mailing address

133 S COLLEGE AVE SUITE 101
COLLEGE PLACE WA
99324-1193
US

V. Phone/Fax

Practice location:
  • Phone: 509-527-2425
  • Fax:
Mailing address:
  • Phone: 509-527-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30006252
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: