Provider Demographics
NPI:1295756740
Name:TURNER, JENNIFER MICHELLE (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:SPANGDAHLEM AFB 52D MEDICAL GROUP
Mailing Address - Street 2:UNIT 3865
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09126-3865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 HOUSE AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3176
Practice Address - Country:US
Practice Address - Phone:307-634-5216
Practice Address - Fax:307-638-6675
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WY20908.259363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY117435500Medicaid
WY117435500Medicaid
WY9796Medicare ID - Type Unspecified