MEDICARE: ASHLEY NICOLE NORTON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PD15046	AR

General Provider Information

NPI Number	:	1184261174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NICOLE NORTON PHARMD

Provider Business Mailing Address
First Line	:	1721 OKMULGEE CT
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-4526
Country	:	US
Telephone Number	:	870-489-1099
Fax Number	:

Provider Business Practice Location Address
First Line	:	4403 CAMP ROBINSON RD STE A
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118-3699
Country	:	US
Telephone Number	:	501-758-6360
Fax Number	:	501-758-6361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2019
Last Update Date	:	01/24/2020

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