MEDICARE: MS. KANETTE TURNER RN

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	163W00000X	Registered Nurse	143424	MO

General Provider Information

NPI Number	:	1508859851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KANETTE TURNER RN

Provider Business Mailing Address
First Line	:	5471 MARTIN LUTHER KING BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63140-1623
Country	:	US
Telephone Number	:	314-367-5820
Fax Number	:	314-367-7010

Provider Business Practice Location Address
First Line	:	5471 MARTIN LUTHER KING BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63140-1623
Country	:	US
Telephone Number	:	314-367-5820
Fax Number	:	314-367-7010

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	07/08/2007

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