Provider Demographics
NPI:1477683811
Name:TURNER, WATONNA LYNN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:WATONNA
Middle Name:LYNN
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 1:132 VENTURE PATH
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2674
Mailing Address - Country:US
Mailing Address - Phone:770-222-6261
Mailing Address - Fax:
Practice Address - Street 1:126 ENTERPRISE PATH
Practice Address - Street 2:SUITE 106
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2656
Practice Address - Country:US
Practice Address - Phone:770-439-9119
Practice Address - Fax:770-439-9194
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN123210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily