Provider Demographics
NPI:1871924316
Name:NORRIS, ASHLEY JORDAN (CRNA, PMHNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JORDAN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CRNA, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MAST RD APT 3
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:NH
Mailing Address - Zip Code:03861-6570
Mailing Address - Country:US
Mailing Address - Phone:802-989-2666
Mailing Address - Fax:802-277-7321
Practice Address - Street 1:3 MAST RD APT 3
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:NH
Practice Address - Zip Code:03861-6570
Practice Address - Country:US
Practice Address - Phone:802-989-2666
Practice Address - Fax:802-277-7321
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013008367500000X
VT101.0110539363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered