Provider Demographics
NPI:1881923472
Name:NOREM, NATALIE ROSEMARIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ROSEMARIE
Last Name:NOREM
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:ROSEMARIE
Other - Last Name:OLENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:PO BOX 31235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1235
Mailing Address - Country:US
Mailing Address - Phone:520-324-4100
Mailing Address - Fax:520-324-1406
Practice Address - Street 1:2424 N WYATT DR STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6119
Practice Address - Country:US
Practice Address - Phone:520-324-8621
Practice Address - Fax:520-324-3935
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10003363LF0000X
MI4704270693363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ279498Medicaid