MEDICARE: JADE NORMAN PA

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1134017270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADE NORMAN PA

Provider Business Mailing Address
First Line	:	210 PETERS GLENN CT
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-8312
Country	:	US
Telephone Number	:	404-643-4257
Fax Number	:

Provider Business Practice Location Address
First Line	:	2199 COLLEGE AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30317-1334
Country	:	US
Telephone Number	:	770-809-1100
Fax Number	:

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

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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Directions to “ JADE NORMAN PA” Practice Location

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