Provider Demographics
NPI:1861819377
Name:TURNER, KELLY A (FNPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:TURNER
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:PELC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-1599
Mailing Address - Country:US
Mailing Address - Phone:207-992-9200
Mailing Address - Fax:
Practice Address - Street 1:1068 UNION ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3016
Practice Address - Country:US
Practice Address - Phone:207-404-8181
Practice Address - Fax:207-922-4198
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily