Individual
ELLEN ARD NORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9 HAWTHORNE PARK CT, GREENVILLE, SC 29615-3194
(864) 603-5600
(864) 239-6645
Mailing address
PO BOX 936934, ATLANTA, GA 31193-6934
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A902
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A406PA
—
SC
Enumeration date
10/04/2006
Last updated
10/03/2022
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