Basic Information
| Provider Information | |||||||||
| NPI: | 1124014972 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | LANAYA | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 COLE AVE | ||||||||
| Address2: | |||||||||
| City: | BISBEE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856031327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204322042 | ||||||||
| FaxNumber: | 5204325082 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 COLE AVE | ||||||||
| Address2: | |||||||||
| City: | BISBEE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856031327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204322042 | ||||||||
| FaxNumber: | 5204322098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 02/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 073726 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 831976 | 05 | AZ | MEDICAID |