Provider Demographics
NPI:1629837620
Name:TURNER, LAVERNE KAREN (LPN)
Entity Type:Individual
Prefix:
First Name:LAVERNE
Middle Name:KAREN
Last Name:TURNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PINE RIDGE I
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5673
Mailing Address - Country:US
Mailing Address - Phone:518-379-5226
Mailing Address - Fax:
Practice Address - Street 1:20 PINE RIDGE I # 20
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-5673
Practice Address - Country:US
Practice Address - Phone:518-379-5226
Practice Address - Fax:518-379-5760
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292254-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse