Healthcare Provider Details

I. General information

NPI: 1891244968
Provider Name (Legal Business Name): KIMBERLY ANNA NORTON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2016
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 LASALLE RD 250
TOWSON MD
20176-6839
US

IV. Provider business mailing address

1400 FRONT AVENUE SUITE 300
LUTHERVILLE MD
21093-6839
US

V. Phone/Fax

Practice location:
  • Phone: 443-279-6262
  • Fax:
Mailing address:
  • Phone: 410-296-7190
  • Fax: 443-991-7768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024173992
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR191358
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: