Healthcare Provider Details

I. General information

NPI: 1114320231
Provider Name (Legal Business Name): NORMA LEATRICE POINDEXTER DNP, RN, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 SUGAR SPRINGS DR SW
MARIETTA GA
30008-3525
US

IV. Provider business mailing address

1106 SUGAR SPRINGS DR SW
MARIETTA GA
30008-3525
US

V. Phone/Fax

Practice location:
  • Phone: 404-630-3520
  • Fax: 770-919-0304
Mailing address:
  • Phone: 404-630-3520
  • Fax: 770-919-0304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN159043
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: