Provider Demographics
NPI:1679594196
Name:NORWOOD, VICKY R (FNP)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:R
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 W JAGGED ROCK RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-8308
Mailing Address - Country:US
Mailing Address - Phone:520-904-1539
Mailing Address - Fax:520-544-0042
Practice Address - Street 1:7225 N PASEO DEL NORTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-904-1539
Practice Address - Fax:520-544-0042
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ815730Medicaid
AZZ111268Medicare PIN
AZ815730Medicaid
AZQ00759Medicare UPIN