Provider Demographics
NPI:1518306950
Name:TURNER, OLGA (RN)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DOE PATH
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-2139
Mailing Address - Country:US
Mailing Address - Phone:631-403-4028
Mailing Address - Fax:
Practice Address - Street 1:3 DOE PATH
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-2139
Practice Address - Country:US
Practice Address - Phone:631-403-4028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY644094-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY644094-1Medicaid