Basic Information
| Provider Information | |||||||||
| NPI: | 1033140595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | MARTRICIA | ||||||||
| MiddleName: | MESHONNA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3805 CHEROKEE ST NW | ||||||||
| Address2: | |||||||||
| City: | KENNESAW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301442085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704265666 | ||||||||
| FaxNumber: | 7704266205 | ||||||||
| Practice Location | |||||||||
| Address1: | 3805 CHEROKEE ST NW | ||||||||
| Address2: | |||||||||
| City: | KENNESAW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301442085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704265666 | ||||||||
| FaxNumber: | 7704266205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 07/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN150217 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.