Provider Demographics
NPI:1831181049
Name:GARRETT, NORMA PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:NORMA PATRICIA
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N MIDVALE BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5072
Mailing Address - Country:US
Mailing Address - Phone:608-663-5925
Mailing Address - Fax:608-441-5636
Practice Address - Street 1:222 N MIDVALE BLVD STE 8
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5072
Practice Address - Country:US
Practice Address - Phone:608-663-5925
Practice Address - Fax:608-441-5636
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31440-202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31666800Medicaid
F43622Medicare UPIN
WI31666800Medicaid
WI000384027Medicare PIN