Provider Demographics
NPI:1972103950
Name:NORELLO, CHRIS JOSEPH I
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:JOSEPH
Last Name:NORELLO
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10856 IRELAND DR
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-8159
Mailing Address - Country:US
Mailing Address - Phone:517-599-6149
Mailing Address - Fax:
Practice Address - Street 1:2925 TOWNE CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-5650
Practice Address - Country:US
Practice Address - Phone:517-482-1803
Practice Address - Fax:517-482-9149
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist