Individual
RENA NORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6018 OLD DIXIE HWY, FOREST PARK, GA 30297-3251
(404) 241-2323
Mailing address
6018 OLD DIXIE HWY, FOREST PARK, GA 30297-3251
(404) 241-2323
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
453589
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
453589
GA INSURANCE LICENSE
GA
Enumeration date
10/20/2014
Last updated
10/20/2014
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