Healthcare Provider Details

I. General information

NPI: 1518968296
Provider Name (Legal Business Name): LORNA TURNAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E 3RD ST
PORTAGEVILLE MO
63873-1401
US

IV. Provider business mailing address

203 E 3RD ST
PORTAGEVILLE MO
63873-1401
US

V. Phone/Fax

Practice location:
  • Phone: 573-379-2100
  • Fax: 573-379-2101
Mailing address:
  • Phone: 573-379-2100
  • Fax: 573-379-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORNA A TURNAGE
Title or Position: FNP OWNER
Credential: FNP
Phone: 573-379-2100