Provider Demographics
NPI:1114703576
Name:NORMAN, ROSALYN CARROLL REESE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:CARROLL REESE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ROSALYN
Other - Middle Name:CARROLL
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1620 JERSEY DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6545
Mailing Address - Country:US
Mailing Address - Phone:770-580-5985
Mailing Address - Fax:
Practice Address - Street 1:101 BANKS STA
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7507
Practice Address - Country:US
Practice Address - Phone:404-439-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0310431835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care