Provider Demographics
NPI:1952444879
Name:TURNER, KENDRIA MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:KENDRIA
Middle Name:MARIE
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 1:1305 FOUNTAIN LN
Mailing Address - Street 2:APT A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3291
Mailing Address - Country:US
Mailing Address - Phone:614-986-9067
Mailing Address - Fax:
Practice Address - Street 1:1305 FOUNTAIN LN
Practice Address - Street 2:APT A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3291
Practice Address - Country:US
Practice Address - Phone:614-986-9067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-115017164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2487198Medicaid