Provider Demographics
NPI:1457925778
Name:NORRIS, CYNTHIA YARERY (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:YARERY
Last Name:NORRIS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:YARERY
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CYNTHIA SANCHEZ
Mailing Address - Street 1:3954 AGUA CALIENTE DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7963
Mailing Address - Country:US
Mailing Address - Phone:575-652-7051
Mailing Address - Fax:
Practice Address - Street 1:4815 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2705
Practice Address - Country:US
Practice Address - Phone:915-215-4600
Practice Address - Fax:915-545-7338
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1037692363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty