MEDICARE: KYLE TURNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1427460443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE TURNER

Provider Business Mailing Address
First Line	:	720 WASHINGTON AVE S
Second Line	:	APT 407
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1187
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 E 28TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1394
Country	:	US
Telephone Number	:	612-333-0770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2014
Last Update Date	:	07/16/2014

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Directions to “ KYLE TURNER ” Practice Location

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