Provider Demographics
NPI:1932263084
Name:NORMAN, CAROL A (CFNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:NORMAN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W HARRIE ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:MI
Mailing Address - Zip Code:49868-1209
Mailing Address - Country:US
Mailing Address - Phone:906-293-9200
Mailing Address - Fax:906-586-3264
Practice Address - Street 1:502 W HARRIE ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-1209
Practice Address - Country:US
Practice Address - Phone:906-293-9200
Practice Address - Fax:906-586-3264
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704175210363L00000X
MI4704195331363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704175210OtherNURSE PRACTIONER ID NO.