Provider Demographics
NPI:1629249693
Name:NORTON, SHAUNA (NP)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7594
Mailing Address - Street 2:
Mailing Address - City:NIKISKI
Mailing Address - State:AK
Mailing Address - Zip Code:99635-7594
Mailing Address - Country:US
Mailing Address - Phone:907-782-4544
Mailing Address - Fax:877-253-6065
Practice Address - Street 1:51708 KENAI SPUR HWY # B-7594
Practice Address - Street 2:
Practice Address - City:NIKISKI
Practice Address - State:AK
Practice Address - Zip Code:99635-9800
Practice Address - Country:US
Practice Address - Phone:907-782-4544
Practice Address - Fax:877-253-6065
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT368339-4405363LP0808X
AKNURU1215363LP0808X
AK1215363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174953087OtherGROUP NPI