Provider Demographics
NPI:1396455093
Name:TOURAY, NORWI AISHA
Entity type:Individual
Prefix:
First Name:NORWI
Middle Name:AISHA
Last Name:TOURAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORWI
Other - Middle Name:AISHA
Other - Last Name:TOURAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5102 S NICHOLSON AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-1818
Mailing Address - Country:US
Mailing Address - Phone:414-588-2517
Mailing Address - Fax:
Practice Address - Street 1:5102 S NICHOLSON AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-1818
Practice Address - Country:US
Practice Address - Phone:414-588-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIT600-6218-7641-03172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver