Basic Information
Provider Information
NPI: 1295876142
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNER
FirstName: BRIAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 11225
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374012225
CountryCode: US
TelephoneNumber: 4238925602
FaxNumber:  
Practice Location
Address1: 975 E 3RD ST
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374032103
CountryCode: US
TelephoneNumber: 4237787608
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/12/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN137599TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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