Provider Demographics
NPI:1427797513
Name:NORVELL, BRETT LEIGH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:LEIGH
Last Name:NORVELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 E THUNDERBIRD RD APT 166
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5859
Mailing Address - Country:US
Mailing Address - Phone:618-407-4196
Mailing Address - Fax:
Practice Address - Street 1:4025 E THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5836
Practice Address - Country:US
Practice Address - Phone:602-953-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist