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General NPI Number Information
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NPI Number | 1306733324
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Entity Type | Individual
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Provider Name | MS. STACY NORVELL
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 6641 N HIGH ST STE 104
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City | WORTHINGTON
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State | OH
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Zip | 43085-4038
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Country | US
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Telephone | 614-885-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 ROLLING ROCK CT
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City | COLUMBUS
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State | OH
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Zip | 43229-4783
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Country | US
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Telephone | 614-226-6459
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 123456
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License Number State | OH
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