Healthcare Provider Details

I. General information

NPI: 1255306874
Provider Name (Legal Business Name): SUZANNE B. NORGANG CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 WATER ST
BLUE HILL ME
04614
US

IV. Provider business mailing address

57 WATER STREET
BLUE HILL ME
04614
US

V. Phone/Fax

Practice location:
  • Phone: 207-374-3940
  • Fax: 207-374-3980
Mailing address:
  • Phone: 207-374-3940
  • Fax: 207-374-3980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM82084
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010115
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: