Provider Demographics
NPI:1982107207
Name:NORRELL, LUCY OBIANUJU (DNP)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:OBIANUJU
Last Name:NORRELL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 FREEDOM RD
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082-1212
Mailing Address - Country:US
Mailing Address - Phone:719-398-0806
Mailing Address - Fax:
Practice Address - Street 1:2202 FREEDOM RD
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-1212
Practice Address - Country:US
Practice Address - Phone:719-398-0806
Practice Address - Fax:719-574-4066
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0004466-C-NP363LF0000X
NM61533363LF0000X
TXAP136391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty