Healthcare Provider Details

I. General information

NPI: 1235420803
Provider Name (Legal Business Name): MISS JOANNE JESSE TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 MEMORIAL CIRCLE
CLARKSVILLE TN
37043
US

IV. Provider business mailing address

683 PARIS PIKE
MC KENZIE TN
38201-1317
US

V. Phone/Fax

Practice location:
  • Phone: 931-920-7333
  • Fax:
Mailing address:
  • Phone: 731-415-1819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: