Healthcare Provider Details

I. General information

NPI: 1316867542
Provider Name (Legal Business Name): KAITLYN TURNER BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 CHESTNUT ST
TERRE HAUTE IN
47809-1910
US

IV. Provider business mailing address

3360 W CHICKEN RUN RD
MADISON IN
47250-7919
US

V. Phone/Fax

Practice location:
  • Phone: 812-237-3410
  • Fax:
Mailing address:
  • Phone: 812-571-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: