MEDICARE: ANGELINA NORMAN CRNP

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	327922	AZ

General Provider Information

NPI Number	:	1447903836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINA NORMAN CRNP

Provider Business Mailing Address
First Line	:	4539 N 22ND ST # 8118
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	928-365-0365
Fax Number	:	877-767-7660

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST # 8118
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	928-365-0365
Fax Number	:	877-767-7660

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

Provider Enumeration Date	:	01/27/2022
Last Update Date	:	02/03/2026

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