Healthcare Provider Details

I. General information

NPI: 1003950882
Provider Name (Legal Business Name): JEANNE M NORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S HAVANA ST
AURORA CO
80014-1618
US

IV. Provider business mailing address

10657 AMESBURY WAY
HIGHLANDS RANCH CO
80126-8042
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-3333
  • Fax:
Mailing address:
  • Phone: 303-683-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number169341
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: