Healthcare Provider Details

I. General information

NPI: 1396335287
Provider Name (Legal Business Name): MARISSA TURNER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 ISLAND DR STE 1
FORT PIERRE SD
57532-7303
US

IV. Provider business mailing address

202 ISLAND DR STE 1
FORT PIERRE SD
57532-7303
US

V. Phone/Fax

Practice location:
  • Phone: 605-223-2200
  • Fax: 605-223-2995
Mailing address:
  • Phone: 605-223-2200
  • Fax: 605-223-2995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001954
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: