1528142544 NPI number — KELLI A. TURNER, DDS, PC

Table of content: (NPI 1528142544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528142544 NPI number — KELLI A. TURNER, DDS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KELLI A. TURNER, DDS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR. KELLI A. TURNER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528142544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1506 CHURCH ST
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-3019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-321-2702
Provider Business Mailing Address Fax Number:
615-327-0090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1506 CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-3019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-321-2702
Provider Business Practice Location Address Fax Number:
615-327-0090
Provider Enumeration Date:
10/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
KELLI
Authorized Official Middle Name:
ARNET
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-321-2702

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  5305 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3225743 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".