Basic Information
| Provider Information | |||||||||
| NPI: | 1942574645 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NORRIS | ||||||||
| FirstName: | TARA | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4704 CHESTNUT WAY | ||||||||
| Address2: | |||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729032312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4798838059 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7217 CAMERON PARK DR | ||||||||
| Address2: | |||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729036167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4798316007 | ||||||||
| FaxNumber: | 4797821242 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2012 | ||||||||
| LastUpdateDate: | 10/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | A03653 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.