Healthcare Provider Details

I. General information

NPI: 1225952377
Provider Name (Legal Business Name): MAKENNA BONNIE KAY TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13845 S 261ST EAST AVE
COWETA OK
74429-5615
US

IV. Provider business mailing address

13845 S 261ST EAST AVE
COWETA OK
74429-5615
US

V. Phone/Fax

Practice location:
  • Phone: 918-232-1081
  • Fax:
Mailing address:
  • Phone: 918-232-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: