Healthcare Provider Details

I. General information

NPI: 1538109954
Provider Name (Legal Business Name): MICHELLE MARIE TURNER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 W BALTIMORE ST
BALTIMORE MD
21201-1110
US

IV. Provider business mailing address

PO BOX 65034
BALTIMORE MD
21264-5034
US

V. Phone/Fax

Practice location:
  • Phone: 410-369-5200
  • Fax: 410-347-0870
Mailing address:
  • Phone: 410-369-5200
  • Fax: 410-347-0870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR162370
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: