Provider Demographics
NPI:1851274906
Name:NORMAN, NATASHA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 BUNDY CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0903
Mailing Address - Country:US
Mailing Address - Phone:910-578-7773
Mailing Address - Fax:910-578-7773
Practice Address - Street 1:6005 BUNDY CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0903
Practice Address - Country:US
Practice Address - Phone:910-578-7773
Practice Address - Fax:910-578-7773
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health