Provider Demographics
NPI:1578832614
Name:TURPEN, STACY LANETTE (PT)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LANETTE
Last Name:TURPEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLEFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79339-5409
Mailing Address - Country:US
Mailing Address - Phone:806-729-6274
Mailing Address - Fax:
Practice Address - Street 1:1241 E MARSHALL HOWARD BLVD
Practice Address - Street 2:
Practice Address - City:LITTLEFIELD
Practice Address - State:TX
Practice Address - Zip Code:79339-5635
Practice Address - Country:US
Practice Address - Phone:806-385-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist