Provider Demographics
NPI:1972667954
Name:TURK, PAMELA K (APRN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:K
Last Name:TURK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 DOCTORS DR 106
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-2202
Mailing Address - Country:US
Mailing Address - Phone:912-384-3338
Mailing Address - Fax:912-384-8214
Practice Address - Street 1:200 DOCTORS DR 106
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2202
Practice Address - Country:US
Practice Address - Phone:912-384-3338
Practice Address - Fax:912-384-8214
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR101998363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000845248CMedicaid
GA50BBJPJMedicare ID - Type Unspecified
GA000845248CMedicaid