Provider Demographics
NPI:1497511307
Name:NORTON, MICHAEL K
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:K
Last Name:NORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 RICHLAND CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29626-6563
Mailing Address - Country:US
Mailing Address - Phone:864-933-3547
Mailing Address - Fax:
Practice Address - Street 1:510 RICHLAND CREEK RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29626-6563
Practice Address - Country:US
Practice Address - Phone:864-933-3547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC245841163W00000X
SC28538363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse