Healthcare Provider Details

I. General information

NPI: 1053200824
Provider Name (Legal Business Name): TERRY WAYNE NORTON RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 07/13/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 BRUNELLE AVE
SANFORD ME
04073-5533
US

IV. Provider business mailing address

30 BRUNELLE AVE
SANFORD ME
04073-5533
US

V. Phone/Fax

Practice location:
  • Phone: 207-651-3614
  • Fax: 207-651-3614
Mailing address:
  • Phone: 207-651-3614
  • Fax: 207-651-3614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN82210
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: