Provider Demographics
NPI:1023875317
Name:TURNER, MANDY (NP)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 LONE OAK RD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-9558
Mailing Address - Country:US
Mailing Address - Phone:360-747-1073
Mailing Address - Fax:
Practice Address - Street 1:1339 COMMERCE AVE STE 312
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3729
Practice Address - Country:US
Practice Address - Phone:360-747-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP616668597363LF0000X
WARN60067650163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse