Provider Demographics
NPI:1285662320
Name:TURNER, JENNIFER ANDREA (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANDREA
Last Name:TURNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7824 SOLARI CT
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-7004
Mailing Address - Country:US
Mailing Address - Phone:410-808-5255
Mailing Address - Fax:
Practice Address - Street 1:CATONSVILLE PHYSICAL THERAPY 700 GEIPE RD
Practice Address - Street 2:STE 240
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-747-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT-5603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD189NP879Medicare PIN