Healthcare Provider Details

I. General information

NPI: 1982334066
Provider Name (Legal Business Name): ELIZABETH GREY NORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5703 S SAGINAW RD
GRAND BLANC MI
48507-4459
US

IV. Provider business mailing address

1492 W STANLEY RD
MOUNT MORRIS MI
48458-2333
US

V. Phone/Fax

Practice location:
  • Phone: 810-695-4623
  • Fax:
Mailing address:
  • Phone: 425-583-0513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302418990
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: