Provider Demographics
NPI:1780620005
Name:NORRIS, BARBARA ANN (APRN,BC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46613-3205
Mailing Address - Country:US
Mailing Address - Phone:574-234-0851
Mailing Address - Fax:574-234-7072
Practice Address - Street 1:1432 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46613-3205
Practice Address - Country:US
Practice Address - Phone:574-234-0851
Practice Address - Fax:574-234-7072
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN222130AMedicare PIN
IND95602Medicare UPIN