MEDICARE: DR. ROSA NORRIS NP-C, DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	TAP5665	AZ
2	363LF0000X	Family Nurse Practitioner	AP5665	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP5665	AZ

General Provider Information

NPI Number	:	1306251327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSA NORRIS NP-C, DNP

Provider Business Mailing Address
First Line	:	13210 W VAN BUREN ST STE 100
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85338-1164
Country	:	US
Telephone Number	:	623-592-5800
Fax Number	:	623-259-5858

Provider Business Practice Location Address
First Line	:	13210 W VAN BUREN ST STE 100
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85338-1164
Country	:	US
Telephone Number	:	623-259-5800
Fax Number	:	623-259-5858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2014
Last Update Date	:	02/23/2023

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