Provider Demographics
NPI:1558885525
Name:TURNER, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:
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 614
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:VA
Mailing Address - Zip Code:23303-0614
Mailing Address - Country:US
Mailing Address - Phone:757-328-1948
Mailing Address - Fax:
Practice Address - Street 1:32380 NOCKS LANDING RD
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:VA
Practice Address - Zip Code:23303-2626
Practice Address - Country:US
Practice Address - Phone:757-328-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty