Provider Demographics
NPI:1821713926
Name:NORVILLE, ABIGAIL RENEE (RN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:RENEE
Last Name:NORVILLE
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 1:895 N 900 EAST RD
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:IL
Mailing Address - Zip Code:62556-7020
Mailing Address - Country:US
Mailing Address - Phone:217-820-5644
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-955-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020001551163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine