Provider Demographics
NPI:1003525882
Name:TURNER, THERESA LOUISE
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LOUISE
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 SAIL BOAT RUN APT 2C
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4272
Mailing Address - Country:US
Mailing Address - Phone:412-670-0820
Mailing Address - Fax:
Practice Address - Street 1:339 SAIL BOAT RUN APT 2C
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-4272
Practice Address - Country:US
Practice Address - Phone:412-670-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant