Provider Demographics
NPI:1982340543
Name:TURNER, SHANNON L
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:L
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:L
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPBT, CPIV
Mailing Address - Street 1:1440 SUNNY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1124
Mailing Address - Country:US
Mailing Address - Phone:877-552-3311
Mailing Address - Fax:
Practice Address - Street 1:1440 SUNNY GLEN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1124
Practice Address - Country:US
Practice Address - Phone:877-552-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30117246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty