Provider Demographics
NPI:1851757603
Name:BRACAMONTE, NORMA ANN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:ANN
Last Name:BRACAMONTE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:2506 E VISTOSO COMMERCE LOOP STE 100
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-9112
Practice Address - Country:US
Practice Address - Phone:520-797-3111
Practice Address - Fax:520-326-2575
Is Sole Proprietor?:No
Enumeration Date:2016-01-10
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8312363L00000X, 363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner