Provider Demographics
NPI:1740651983
Name:NORMAN, ALICE GENNETTE
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:GENNETTE
Last Name:NORMAN
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 1:508 CATINA WAY
Mailing Address - Street 2:APT 9
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-3913
Mailing Address - Country:US
Mailing Address - Phone:757-376-5395
Mailing Address - Fax:
Practice Address - Street 1:508 CATINA WAY
Practice Address - Street 2:APT 9
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-3913
Practice Address - Country:US
Practice Address - Phone:757-376-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health