Healthcare Provider Details

I. General information

NPI: 1205722600
Provider Name (Legal Business Name): EMMARIE NORTON RN, DNP STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PAULINA ST # 1080
CHICAGO IL
60612-3806
US

IV. Provider business mailing address

5503 UPLAND TRL
MIDDLETON WI
53562-5222
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-7117
  • Fax:
Mailing address:
  • Phone: 507-358-9722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: