Provider Demographics
NPI:1962400606
Name:NORWOOD, CONNIS (NP-C)
Entity type:Individual
Prefix:MS
First Name:CONNIS
Middle Name:
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 BOND ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-0307
Mailing Address - Country:US
Mailing Address - Phone:770-205-5518
Mailing Address - Fax:770-205-5519
Practice Address - Street 1:5830 BOND ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-0307
Practice Address - Country:US
Practice Address - Phone:770-205-5518
Practice Address - Fax:770-205-5519
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN045021NP363LC1500X
GAF0303018364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN045021NPOtherGA NURSE PRACT LICENSE #