Provider Demographics
NPI:1144824053
Name:NORMAN, BRIGETTE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BRIGETTE
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:BRIGETTE
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:913 SAINT JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-2867
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9315 N LINDBERGH DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-1454
Practice Address - Country:US
Practice Address - Phone:309-691-7738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051298635OtherPHARMACIST