Provider Demographics
NPI:1962286237
Name:NORRIS, AFSANEH (NP)
Entity type:Individual
Prefix:
First Name:AFSANEH
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-242-4384
Mailing Address - Fax:541-463-2820
Practice Address - Street 1:330 S GARDEN WAY STE 350
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8179
Practice Address - Country:US
Practice Address - Phone:541-746-6816
Practice Address - Fax:541-726-3177
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF08230430363LF0000X
OR10015485363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily