Provider Demographics
NPI:1013947258
Name:TURNER, KRISTA L (MD)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2745
Mailing Address - Country:US
Mailing Address - Phone:505-272-6441
Mailing Address - Fax:
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2745
Practice Address - Country:US
Practice Address - Phone:505-272-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM13892086S0102X
NMMD2012-08432086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01048889OtherRR MEDICARE
TX174554903Medicaid
TX174554904OtherCSHCN (CHILDREN WITH SPECIAL HEALTH CARE NEEDS)
TXP00366714OtherMEDICARE RAILROAD
TX8V8606OtherBLUE CROSS BLUE SHIELD
TX174554905Medicaid
TX8G9211Medicare PIN
TX8V8606OtherBLUE CROSS BLUE SHIELD
TX174554904OtherCSHCN (CHILDREN WITH SPECIAL HEALTH CARE NEEDS)