Provider Demographics
NPI:1487026290
Name:NORGART, LYUDMYLA (NP-C)
Entity type:Individual
Prefix:
First Name:LYUDMYLA
Middle Name:
Last Name:NORGART
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:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:ID
Mailing Address - Zip Code:83455-0967
Mailing Address - Country:US
Mailing Address - Phone:813-230-4241
Mailing Address - Fax:
Practice Address - Street 1:40 E LITTLE AVE
Practice Address - Street 2:
Practice Address - City:DRIGGS
Practice Address - State:ID
Practice Address - Zip Code:83422-5138
Practice Address - Country:US
Practice Address - Phone:208-354-8220
Practice Address - Fax:208-561-7457
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9379318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily