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General NPI Number Information
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NPI Number | 1114703576
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Entity Type | Individual
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Provider Name | ROSALYN CARROLL REESE NORMAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 101 BANKS STA
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7507
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Country | US
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Telephone | 404-439-4456
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 JERSEY DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6545
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Country | US
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Telephone | 770-580-5985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | RPH031043
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License Number State | GA
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