Healthcare Provider Details

I. General information

NPI: 1104751387
Provider Name (Legal Business Name): GRACE NORMAN EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 MOORE ST
WESTMINSTER CO
80021-5114
US

IV. Provider business mailing address

10330 MOORE ST
WESTMINSTER CO
80021-5114
US

V. Phone/Fax

Practice location:
  • Phone: 303-819-0447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberQ221717
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: