Healthcare Provider Details

I. General information

NPI: 1114906153
Provider Name (Legal Business Name): CAROL B NORTON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HAWTHORNE AVE SUITE J
ATHENS GA
30606-2168
US

IV. Provider business mailing address

1835 SAVOY DR SUITE 300
ATLANTA GA
30341-1072
US

V. Phone/Fax

Practice location:
  • Phone: 706-369-4478
  • Fax: 706-353-6639
Mailing address:
  • Phone: 706-676-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN098033
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: