MEDICARE: RAINA NORRIS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11038854	FL

General Provider Information

NPI Number	:	1396530747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAINA NORRIS

Provider Business Mailing Address
First Line	:	PO BOX 1012
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33568-1012
Country	:	US
Telephone Number	:	813-380-0605
Fax Number	:

Provider Business Practice Location Address
First Line	:	4522 W VILLAGE DR UNIT 1091
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-3429
Country	:	US
Telephone Number	:	813-380-0605
Fax Number	:

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

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	04/14/2025

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Directions to “ RAINA NORRIS ” Practice Location

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