Provider Demographics
NPI:1710277595
Name:TURNOCK, TANYA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:MARIE
Last Name:TURNOCK
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 1:510 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:MN
Mailing Address - Zip Code:56209-1015
Mailing Address - Country:US
Mailing Address - Phone:651-353-1229
Mailing Address - Fax:
Practice Address - Street 1:510 2ND ST S
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:MN
Practice Address - Zip Code:56209-1015
Practice Address - Country:US
Practice Address - Phone:651-353-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL63536-5164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse