Healthcare Provider Details

I. General information

NPI: 1497834972
Provider Name (Legal Business Name): KATHRYN A TURK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 W SOUTHERN AVE STE. A1
APACHE JUNCTION AZ
85220-7455
US

IV. Provider business mailing address

4026 N TERRA MESA CIR
MESA AZ
85207-1474
US

V. Phone/Fax

Practice location:
  • Phone: 480-353-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN129872
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: