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General NPI Number Information
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NPI Number | 1366749764
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Entity Type | Individual
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Provider Name | SUSAN M NORRIS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/21/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 17959 MAIN STREET
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City | EMINENCE
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State | MO
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Zip | 65466
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Country | US
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Telephone | 573-226-5505
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Fax | 573-226-5584
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Provider Business Mailing Address
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Address Line | PO BOX 157
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City | ELLINGTON
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State | MO
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Zip | 63638-0157
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Country | US
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Telephone | 573-323-0423
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Fax | 573-323-8931
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2011002322
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License Number State | MO
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