1467882340 NPI number — MOLLY MCKEE TURNER APRN

Table of content: MOLLY MCKEE TURNER APRN (NPI 1467882340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467882340 NPI number — MOLLY MCKEE TURNER APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
MOLLY
Provider Middle Name:
MCKEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCKEE
Provider Other First Name:
MOLLY
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467882340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
836 PRUDENTIAL DR STE 1103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32207-8338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-398-7654
Provider Business Mailing Address Fax Number:
904-398-0118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
836 PRUDENTIAL DR
Provider Second Line Business Practice Location Address:
SUITE 1103
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32207-8334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-398-9499
Provider Business Practice Location Address Fax Number:
904-398-0118
Provider Enumeration Date:
11/14/2013

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: 363LW0102X , with the licence number:  APRN9374234 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 010613500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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