Individual
MRS. JACELYN NORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22895 BRAMBLETON PLZ, SUITE 200, BRAMBLETON, VA 20148-4876
(703) 327-3173
(703) 740-8317
Mailing address
212 LINDEN DR, SUITE 154, WINCHESTER, VA 22601-2894
(540) 535-0777
(703) 740-8317
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002333
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003995200
—
VA
01
—
P00667931
RR MEDICARE
VA
Enumeration date
11/06/2006
Last updated
05/07/2012
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