1619918927 NPI number — SHARON L TURKALY CRNA

Table of content: SHARON L TURKALY CRNA (NPI 1619918927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619918927 NPI number — SHARON L TURKALY CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURKALY
Provider First Name:
SHARON
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1619918927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR 2 BOX 170B
Provider Second Line Business Mailing Address:
4 CRESTON ROAD
Provider Business Mailing Address City Name:
COTTAGEVILLE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25239-9532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-545-0965
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RR 2 BOX 170B
Provider Second Line Business Practice Location Address:
4 CRESTON ROAD
Provider Business Practice Location Address City Name:
COTTAGEVILLE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25239-9532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-545-0965
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  35526 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001775623 . This is a "BCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0279318 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00001161 . This is a "RR MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 232946909 . This is a "TRICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001775623 . This is a "MSBCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 1069143 . This is a "WV WORKER'S COMP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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