Basic Information
Provider Information | |||||||||
NPI: | 1679772115 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | TURNER | ||||||||
FirstName: | CHRISTINA | ||||||||
MiddleName: | MARIE | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | PCA | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | TURNER | ||||||||
OtherFirstName: | CHRISTINA | ||||||||
OtherMiddleName: | MARIE | ||||||||
OtherNamePrefix: | MRS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 1290 W HORIZON RIDGE PKWY APT 2124 | ||||||||
Address2: |   | ||||||||
City: | HENDERSON | ||||||||
State: | NV | ||||||||
PostalCode: | 890125533 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7029648428 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 160 E HORIZON DR STE A | ||||||||
Address2: |   | ||||||||
City: | HENDERSON | ||||||||
State: | NV | ||||||||
PostalCode: | 890157934 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7026443600 | ||||||||
FaxNumber: | 7027195665 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/14/2007 | ||||||||
LastUpdateDate: | 03/17/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 372600000X |   | NV | N |   | Nursing Service Related Providers | Adult Companion |   | 3747A0650X |   | NV | N |   | Nursing Service Related Providers | Technician | Attendant Care Provider | 376J00000X |   | NV | N |   | Nursing Service Related Providers | Homemaker |   | 171W00000X |   |   | Y |   | Other Service Providers | Contractor |   |
No ID Information.