Provider Demographics
NPI:1790511558
Name:TURNER, KATELYN NICOLE
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:NICOLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 SETTLERS LN
Mailing Address - Street 2:
Mailing Address - City:CAPON BRIDGE
Mailing Address - State:WV
Mailing Address - Zip Code:26711-9063
Mailing Address - Country:US
Mailing Address - Phone:540-533-7925
Mailing Address - Fax:
Practice Address - Street 1:301 S KING ST
Practice Address - Street 2:
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-7000
Practice Address - Country:US
Practice Address - Phone:304-876-5282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program