Provider Demographics
NPI:1033726690
Name:NORMAN, KIMBERLY A
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:NORMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 MOUNT VERNON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-6558
Mailing Address - Country:US
Mailing Address - Phone:306-078-8083
Mailing Address - Fax:
Practice Address - Street 1:3805 MOUNT VERNON BLVD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-6558
Practice Address - Country:US
Practice Address - Phone:330-607-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker