Provider Demographics
NPI:1114929700
Name:TURPEN, KATHERINE TACKETT (AUD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:TACKETT
Last Name:TURPEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6242 POPLAR AVE
Mailing Address - Street 2:HEARING AND BALANCE CENTERS OF WEST TN
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4730
Mailing Address - Country:US
Mailing Address - Phone:901-842-4327
Mailing Address - Fax:901-842-4330
Practice Address - Street 1:6242 POPLAR AVE
Practice Address - Street 2:HEARING AND BALANCE CENTERS OF WEST TN
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4730
Practice Address - Country:US
Practice Address - Phone:901-842-4327
Practice Address - Fax:901-842-4330
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA167174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3192861Medicare ID - Type Unspecified