Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP126415 | TX |
NPI | 1053716787 |
---|---|
Provider Name | Mrs. Tasha Norman |
First Address | Pflugerville, TX 78660-3056 |
Second Address | Cedar Park, TX 78613-4194 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2014 |
Last Update Date | 04/02/2022 |