Healthcare Provider Details

I. General information

NPI: 1871545905
Provider Name (Legal Business Name): JEAN R TURNEY-SHAW FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 SUNSET PT STE A
MIAMI AZ
85539-1347
US

IV. Provider business mailing address

850 S VERDE LN
GLOBE AZ
85501-2008
US

V. Phone/Fax

Practice location:
  • Phone: 928-961-1554
  • Fax: 928-793-3926
Mailing address:
  • Phone: 928-961-1554
  • Fax: 928-793-3926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1479
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: