1760503387 NPI number — MICHELLE TURNER C.P.N.P., I.B.C.L.C.

Table of content: MICHELLE TURNER C.P.N.P., I.B.C.L.C. (NPI 1760503387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760503387 NPI number — MICHELLE TURNER C.P.N.P., I.B.C.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
MICHELLE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
C.P.N.P., I.B.C.L.C.
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:
1760503387
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
998 OLD COUNTRY RD STE C
Provider Second Line Business Mailing Address:
STE. 159
Provider Business Mailing Address City Name:
PLAINVIEW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11803-4936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-502-5255
Provider Business Mailing Address Fax Number:
886-253-3425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
998 OLD COUNTRY RD STE C
Provider Second Line Business Practice Location Address:
STE. 159
Provider Business Practice Location Address City Name:
PLAINVIEW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11803-4936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-502-5255
Provider Business Practice Location Address Fax Number:
886-253-3425
Provider Enumeration Date:
04/02/2007

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: 363LP0200X , with the licence number:  F381122 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02197473 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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