Provider Demographics
NPI:1558617506
Name:NORMAN, EMILY CATHERINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CATHERINE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:CATHERINE
Other - Last Name:BARTLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:17301 E SPRING VALLEY RD STE F
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86333-4263
Mailing Address - Country:US
Mailing Address - Phone:928-632-4909
Mailing Address - Fax:928-632-4973
Practice Address - Street 1:17301 E SPRING VALLEY RD STE F
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86333
Practice Address - Country:US
Practice Address - Phone:928-632-4909
Practice Address - Fax:928-632-4973
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4485363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ937995Medicaid
AZZ194202Medicare PIN
AZ937995Medicaid