Provider Demographics
NPI:1013214097
Name:TURNER, MARY A (LPN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:A
Last Name:TURNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:BRACE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:330 KAY LARKIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-2307
Mailing Address - Country:US
Mailing Address - Phone:386-329-3780
Mailing Address - Fax:386-385-1269
Practice Address - Street 1:330 KAY LARKIN DRIVE
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-2307
Practice Address - Country:US
Practice Address - Phone:386-329-3780
Practice Address - Fax:386-385-1269
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1071421164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse