Healthcare Provider Details

I. General information

NPI: 1013826908
Provider Name (Legal Business Name): MAKENNA TURCHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9811 W CHARLESTON BLVD STE 2-641
LAS VEGAS NV
89117-7528
US

IV. Provider business mailing address

24800 WINONA ST
DEARBORN MI
48124-1556
US

V. Phone/Fax

Practice location:
  • Phone: 855-864-4322
  • Fax:
Mailing address:
  • Phone: 313-623-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: