Provider Demographics
NPI:1225045750
Name:TURNER, MARILYN ROSE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:ROSE
Last Name:TURNER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 NW LAKE WHITNEY PLACE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986
Mailing Address - Country:US
Mailing Address - Phone:772-621-9993
Mailing Address - Fax:772-621-9923
Practice Address - Street 1:3745 11TH CIRCLE
Practice Address - Street 2:SUITE 108
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-564-9400
Practice Address - Fax:772-978-9166
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP724562363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0320YMedicare ID - Type Unspecified
FLS50845Medicare UPIN