Provider Demographics
NPI:1558949297
Name:TURNER, SHEENA SYLVANITA
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:SYLVANITA
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 1:5500 OAKLEY INDUSTRIAL BLVD APT 417
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-6031
Mailing Address - Country:US
Mailing Address - Phone:267-600-5462
Mailing Address - Fax:
Practice Address - Street 1:5500 OAKLEY INDUSTRIAL BLVD APT 417
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-6031
Practice Address - Country:US
Practice Address - Phone:267-600-5462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85-4123140Medicaid