1942927967 NPI number — KENDALIN MIGNON TURNER HOME HEALTH AIDE

Table of content: KENDALIN MIGNON TURNER HOME HEALTH AIDE (NPI 1942927967)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942927967 NPI number — KENDALIN MIGNON TURNER HOME HEALTH AIDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
KENDALIN
Provider Middle Name:
MIGNON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
HOME HEALTH AIDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TURNER
Provider Other First Name:
KENDALIN
Provider Other Middle Name:
MIGNON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
HOME HEALTH AIDE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942927967
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2624 5TH ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44708-4520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-834-8748
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2624 5TH ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44708-4520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-834-8748
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2022

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: 374U00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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