Provider Demographics
NPI:1801381025
Name:TURCHETTA, CASEY HARRIS
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:HARRIS
Last Name:TURCHETTA
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 1:405 HONEY LOCUST WAY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9227
Mailing Address - Country:US
Mailing Address - Phone:757-975-7433
Mailing Address - Fax:
Practice Address - Street 1:405 HONEY LOCUST WAY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-9227
Practice Address - Country:US
Practice Address - Phone:757-975-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT60395205172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver