Provider Demographics
NPI:1538109954
Name:TURNER, MICHELLE MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:TURNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65034
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-5034
Mailing Address - Country:US
Mailing Address - Phone:410-369-5200
Mailing Address - Fax:410-347-0870
Practice Address - Street 1:850 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1110
Practice Address - Country:US
Practice Address - Phone:410-369-5200
Practice Address - Fax:410-347-0870
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162370363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403209800Medicaid
MD621721-01OtherBLUE CROSS/BLUE SHIELD
DE1000034659Medicaid
DE1000034659Medicaid
MD621721-01OtherBLUE CROSS/BLUE SHIELD
MDH202Medicare PIN