Provider Demographics
NPI:1649275132
Name:TUR, MARIANNE ELENA (FNP, PMHNP)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:ELENA
Last Name:TUR
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 N GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93723-9344
Mailing Address - Country:US
Mailing Address - Phone:559-614-6342
Mailing Address - Fax:
Practice Address - Street 1:4441 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3604
Practice Address - Country:US
Practice Address - Phone:559-600-9141
Practice Address - Fax:559-600-9135
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13327363LP0808X
CA526370/13327363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP13327OtherNP LICENSE
CA526370OtherRN LICENSE
CA526370OtherRN LICENSE
CAQ40522Medicare UPIN