Provider Demographics
NPI:1841942026
Name:NORTON, AMANDA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:NORTON
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 1:15835 WINTER RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:MI
Mailing Address - Zip Code:49220-9788
Mailing Address - Country:US
Mailing Address - Phone:517-252-1250
Mailing Address - Fax:
Practice Address - Street 1:15835 WINTER RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:MI
Practice Address - Zip Code:49220-9788
Practice Address - Country:US
Practice Address - Phone:517-252-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704253919163WC1500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health