Provider Demographics
NPI:1396452801
Name:NORRIS, JESSICA LOCKLEAR (FNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LOCKLEAR
Last Name:NORRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:LOCKLEAR
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:812 CANDY PARK RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-9120
Mailing Address - Country:US
Mailing Address - Phone:910-521-0201
Mailing Address - Fax:910-521-0773
Practice Address - Street 1:812 CANDY PARK RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9120
Practice Address - Country:US
Practice Address - Phone:910-521-0201
Practice Address - Fax:910-521-0773
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017175363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics