Provider Demographics
NPI:1629215470
Name:TURNER, SHELLY A (RPH)
Entity Type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:A
Last Name:TURNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:SHELLY
Other - Middle Name:A
Other - Last Name:PHILBRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:438 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4028
Mailing Address - Country:US
Mailing Address - Phone:207-907-0204
Mailing Address - Fax:
Practice Address - Street 1:438 BIRCH ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4028
Practice Address - Country:US
Practice Address - Phone:207-907-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH 21594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist