Healthcare Provider Details

I. General information

NPI: 1922741396
Provider Name (Legal Business Name): TAMIKA TURNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 MARTIN LUTHER KING JR AVE SW
CAIRO GA
39828-2605
US

IV. Provider business mailing address

195 MARTIN LUTHER KING JR AVE SW
CAIRO GA
39828-2605
US

V. Phone/Fax

Practice location:
  • Phone: 229-397-9262
  • Fax: 229-397-9263
Mailing address:
  • Phone: 229-397-9262
  • Fax: 229-397-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN231135
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: