Healthcare Provider Details

I. General information

NPI: 1033468202
Provider Name (Legal Business Name): TANYA NICOLE TURNER F.N.P-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2012
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20715 E OCOTILLO RD STE. 102
QUEEN CREEK AZ
85142-6118
US

IV. Provider business mailing address

20715 E OCOTILLO RD STE. 102
QUEEN CREEK AZ
85142-6118
US

V. Phone/Fax

Practice location:
  • Phone: 480-987-0987
  • Fax: 480-987-0940
Mailing address:
  • Phone: 480-987-0987
  • Fax: 480-987-0940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP4554
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: