Provider Demographics
NPI:1770892929
Name:NORBURY, AMY SUE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:SUE
Last Name:NORBURY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:NORBURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:7 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1332
Mailing Address - Country:US
Mailing Address - Phone:252-695-6352
Mailing Address - Fax:
Practice Address - Street 1:7 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1332
Practice Address - Country:US
Practice Address - Phone:252-695-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1034142363LF0000X, 363LF0000X
VA0024191655363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004920Medicaid