1821312950 NPI number — MRS. STACEY NICOLE TURNER D.P.T.

Table of content: MRS. STACEY NICOLE TURNER D.P.T. (NPI 1821312950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821312950 NPI number — MRS. STACEY NICOLE TURNER D.P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
STACEY
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
D.P.T.
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:
1821312950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY HOSPITAL 1R132
Provider Second Line Business Mailing Address:
50 NORTH MEDICAL DR.
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84132-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-581-2619
Provider Business Mailing Address Fax Number:
801-581-2525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY HOSPITAL 1R132
Provider Second Line Business Practice Location Address:
50 NORTH MEDICAL DR.
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84132-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-2619
Provider Business Practice Location Address Fax Number:
801-581-2525
Provider Enumeration Date:
03/18/2010

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: 225100000X , with the licence number:  7309720-2401 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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