Provider Demographics
NPI:1003192964
Name:TURLEY, MARY (RP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:TURLEY
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 N 132ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1849
Mailing Address - Country:US
Mailing Address - Phone:402-431-0655
Mailing Address - Fax:402-431-0589
Practice Address - Street 1:3701 N 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-1849
Practice Address - Country:US
Practice Address - Phone:402-431-0655
Practice Address - Fax:402-431-0589
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist