Healthcare Provider Details

I. General information

NPI: 1093081481
Provider Name (Legal Business Name): VINA L DE LA O-TURNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 W I 40 STE 300
AMARILLO TX
79106-2651
US

IV. Provider business mailing address

PO BOX 10009
AMARILLO TX
79116-0009
US

V. Phone/Fax

Practice location:
  • Phone: 806-331-7905
  • Fax: 806-731-1516
Mailing address:
  • Phone: 806-670-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberR47221
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: