Provider Demographics
NPI:1700023124
Name:NORMINGTON, HAVILAH A (RN, MSN)
Entity Type:Individual
Prefix:
First Name:HAVILAH
Middle Name:A
Last Name:NORMINGTON
Suffix:
Gender:F
Credentials:RN, MSN
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2301 SUN VALLEY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2318
Mailing Address - Country:US
Mailing Address - Phone:262-646-4162
Mailing Address - Fax:262-646-2498
Practice Address - Street 1:2301 SUN VALLEY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2318
Practice Address - Country:US
Practice Address - Phone:262-646-4162
Practice Address - Fax:262-646-2498
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI157854-30364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist