Provider Demographics
NPI:1770196172
Name:NORMAN, WILMA (RN)
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20862 LANCELOT LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5933
Mailing Address - Country:US
Mailing Address - Phone:714-655-7970
Mailing Address - Fax:
Practice Address - Street 1:6123 STORNOWAY DR S
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2105
Practice Address - Country:US
Practice Address - Phone:714-655-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)