| Doctor Name: | MICHELLE NORMAN |
| NPI Number: | 1386010833 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | NP-1617A |
| Business Practice Address: | 2705 E 17th St Ammon, ID - 834066601 |
| Business Phone Number: | 2083467501 |
| Business Fax Number: | |
| Mailing Address: | 2705 E 17th St, AMMON |
| State: | ID |
| Postal Code: | 834066601 |
| Phone Number: | 2083467501 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2015 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | NP-1617A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |