Provider Demographics
NPI:1932760279
Name:SMITH-TURNER, BRYAN ANTHONY (RN)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:ANTHONY
Last Name:SMITH-TURNER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:BRYAN
Other - Middle Name:ANTHONY
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:16696 COWELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1254
Mailing Address - Country:US
Mailing Address - Phone:510-772-7820
Mailing Address - Fax:
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:510-772-7820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95183411163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse