Provider Demographics
NPI:1861631632
Name:MOREY, NORMA JEAN
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:MOREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RT. 1 BOX 22
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:MO
Mailing Address - Zip Code:64441
Mailing Address - Country:US
Mailing Address - Phone:660-326-2206
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 22
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:MO
Practice Address - Zip Code:64441-8005
Practice Address - Country:US
Practice Address - Phone:660-326-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO26-2694315171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator