Healthcare Provider Details

I. General information

NPI: 1487026290
Provider Name (Legal Business Name): LYUDMYLA NORGART NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 E LITTLE AVE
DRIGGS ID
83422-5138
US

IV. Provider business mailing address

PO BOX 967
VICTOR ID
83455-0967
US

V. Phone/Fax

Practice location:
  • Phone: 208-354-8220
  • Fax: 208-561-7457
Mailing address:
  • Phone: 813-230-4241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number289216
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number75652
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number55606
License Number StateWY
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9379318
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: