MEDICARE: VANESSA NORTON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	0002-01907	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083654586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA NORTON NP

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	910-579-8363
Fax Number	:	910-579-8306

Provider Business Practice Location Address
First Line	:	9970 BEACH DR SW
Second Line	:	SUITE 1
City	:	CALABASH
State	:	NC
Zip	:	28467-2741
Country	:	US
Telephone Number	:	910-579-8363
Fax Number	:	910-579-8306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	02/19/2013

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