Provider Demographics
NPI:1972858306
Name:NORMAN, JAYME ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:ELIZABETH
Last Name:NORMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:ELIZABETH
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:509 MEMORIAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-6195
Mailing Address - Country:US
Mailing Address - Phone:606-598-5104
Mailing Address - Fax:606-598-0983
Practice Address - Street 1:56 MARIE LANGDON DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6329
Practice Address - Country:US
Practice Address - Phone:606-598-5104
Practice Address - Fax:606-598-0983
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
12419015OtherCAQH
KY7100208820Medicaid