Healthcare Provider Details

I. General information

NPI: 1154985935
Provider Name (Legal Business Name): SHANNON A TURNER MS, CLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON ALISON STOKLEY

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 LOOP RD
TUSCALOOSA AL
35404-5015
US

IV. Provider business mailing address

18393 ARABIAN DR
VANCE AL
35490-3408
US

V. Phone/Fax

Practice location:
  • Phone: 205-554-2000
  • Fax:
Mailing address:
  • Phone: 251-656-7438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number263269
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: