MEDICARE: TURNER SCOTT RAFTER I BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1447748017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TURNER SCOTT RAFTER I BSN

Provider Business Mailing Address
First Line	:	2900 UNIVERSITY AVE SE APT 511
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-3738
Country	:	US
Telephone Number	:	573-647-9551
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 UNIVERSITY AVE SE APT 511
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-3738
Country	:	US
Telephone Number	:	573-647-9551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2018
Last Update Date	:	04/28/2018

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