=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801346531
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAVANA D TURNER ATC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2016
-----------------------------------------------------
Last Update Date | 05/18/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2948 HOGAN DR
-----------------------------------------------------
City | CASPER
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82601-6078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-258-9426
-----------------------------------------------------
Fax | 307-224-6463
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2948 HOGAN DR
-----------------------------------------------------
City | CASPER
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82601-6078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-258-9426
-----------------------------------------------------
Fax | 307-224-6463
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | 116043
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | AT8108
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | 184
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------