Provider Demographics
NPI:1114969771
Name:NORMAN, PENNY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25230 BOROUGH PARK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3519
Mailing Address - Country:US
Mailing Address - Phone:832-813-8086
Mailing Address - Fax:
Practice Address - Street 1:25230 BOROUGH PARK DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3519
Practice Address - Country:US
Practice Address - Phone:832-813-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109337363LW0102X
TX630770363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health