Provider Demographics
NPI:1740780717
Name:TURNER, MARKETTA N (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARKETTA
Middle Name:N
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 1:407 WHISPERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-1447
Mailing Address - Country:US
Mailing Address - Phone:937-520-9424
Mailing Address - Fax:937-520-9424
Practice Address - Street 1:407 WHISPERWOOD DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-1447
Practice Address - Country:US
Practice Address - Phone:937-520-9424
Practice Address - Fax:937-520-9424
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH166157164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0179116Medicaid