Provider Demographics
NPI:1730664392
Name:TUREK, NICOLE K
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:K
Last Name:TUREK
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 1:149 HOUSEMAN AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-3538
Mailing Address - Country:US
Mailing Address - Phone:616-929-3053
Mailing Address - Fax:
Practice Address - Street 1:149 HOUSEMAN AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3538
Practice Address - Country:US
Practice Address - Phone:616-929-3053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor