Individual
JUANITA NORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
58 BIG A ROAD, TOCCOA, GA 30577-6017
(706) 886-8419
(706) 886-4479
Mailing address
274 BIG A RD, TOCCOA, GA 30577-6002
(706) 886-8419
(706) 886-4479
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
75091
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000581677ABEF
—
GA
Enumeration date
08/24/2005
Last updated
09/20/2019
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