Healthcare Provider Details

I. General information

NPI: 1093099210
Provider Name (Legal Business Name): TERESA LEIGH TURNER APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 KIDD DRIVE
BEREA KY
40403
US

IV. Provider business mailing address

208 KIDD DRIVE
BEREA KY
40403
US

V. Phone/Fax

Practice location:
  • Phone: 859-986-1500
  • Fax:
Mailing address:
  • Phone: 859-986-1500
  • Fax: 888-315-2562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3007059
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: