Provider Demographics
NPI:1215478003
Name:NORRIS, BROOKE (BS)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-5072
Mailing Address - Country:US
Mailing Address - Phone:662-643-3362
Mailing Address - Fax:
Practice Address - Street 1:303 N MADISON ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-5072
Practice Address - Country:US
Practice Address - Phone:662-643-3362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator