Provider Demographics
NPI:1962277905
Name:NORRIS, JESSICA BRINSON
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:BRINSON
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:NICOLE
Other - Last Name:BRINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:117 FOX RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-2229
Mailing Address - Country:US
Mailing Address - Phone:478-447-4337
Mailing Address - Fax:
Practice Address - Street 1:5400 RIVERSIDE DR STE 202
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-0818
Practice Address - Country:US
Practice Address - Phone:478-787-0059
Practice Address - Fax:855-428-4597
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily