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General NPI Number Information
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NPI Number | 1730525072
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Entity Type | Individual
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Provider Name | JACQUELINE NORTMAN MD
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Gender | Female
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 1025 W. US HWY. 175
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City | CRANDALL
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State | TX
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Zip | 75114
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Country | US
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Telephone | 972-472-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 W. US HWY. 175
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City | CRANDALL
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State | TX
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Zip | 75114
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Country | US
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Telephone | 972-472-3800
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 30065
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R0628
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License Number State | TX
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