Provider Demographics
NPI:1588792220
Name:NORRIS, THERESA (MSN)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 W JAMES M CAMPBELL BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4659
Mailing Address - Country:US
Mailing Address - Phone:931-540-4140
Mailing Address - Fax:931-540-4142
Practice Address - Street 1:854 W JAMES M CAMPBELL BLVD STE 301
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4659
Practice Address - Country:US
Practice Address - Phone:931-540-4140
Practice Address - Fax:931-540-4142
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TN19367363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator