Provider Demographics
NPI:1184836058
Name:ENGESSER, NORMA J (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:J
Last Name:ENGESSER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HAZEL WOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:GA
Mailing Address - Zip Code:30563-3131
Mailing Address - Country:US
Mailing Address - Phone:170-677-6731
Mailing Address - Fax:
Practice Address - Street 1:185 SCOGGINS DR
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-5355
Practice Address - Country:US
Practice Address - Phone:170-677-8715
Practice Address - Fax:170-677-6769
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN036279163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health