Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 71002012A | IN |
NPI | 1285878918 |
---|---|
Provider Name | Mary Ann Norris |
First Address | Newburgh, IN 47630-8940 |
Second Address | Newburgh, IN 47630-8940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2009 |
Last Update Date | 17/06/2019 |