Provider Demographics
NPI:1255000246
Name:TURNER, RADISHA (LPN)
Entity Type:Individual
Prefix:
First Name:RADISHA
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 SHORELAND DR APT D
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3320
Mailing Address - Country:US
Mailing Address - Phone:131-791-4251
Mailing Address - Fax:
Practice Address - Street 1:2157 SHORELAND DR APT D
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3320
Practice Address - Country:US
Practice Address - Phone:317-914-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27066998A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse