Provider Demographics
NPI:1649629973
Name:TRAVIS-TURNER, JOHANNA (FNP)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:TRAVIS-TURNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:
Other - Last Name:VALENTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:356 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4401
Mailing Address - Country:US
Mailing Address - Phone:212-271-7200
Mailing Address - Fax:212-937-4893
Practice Address - Street 1:356 W 18TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4401
Practice Address - Country:US
Practice Address - Phone:212-271-7200
Practice Address - Fax:212-937-4893
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY702584-1163W00000X
NY33341442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse