Provider Demographics
NPI:1043392574
Name:TURNER, JEANINE ELIZABETH (OD)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:ELIZABETH
Last Name:TURNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHARTER ST
Mailing Address - Street 2:UNIT 20
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2460 LAFAYETTE RD
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5618
Practice Address - Country:US
Practice Address - Phone:603-431-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH715152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2405744OtherCIGNA PROVIDER IDEN. #