Provider Demographics
NPI:1255056859
Name:THURMAN, TAWNYA MARIE (CPHT)
Entity type:Individual
Prefix:
First Name:TAWNYA
Middle Name:MARIE
Last Name:THURMAN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17904 W SANDALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-1599
Mailing Address - Country:US
Mailing Address - Phone:623-882-4470
Mailing Address - Fax:
Practice Address - Street 1:13940 W MEEKER BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4492
Practice Address - Country:US
Practice Address - Phone:623-975-6221
Practice Address - Fax:623-975-6223
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZT071020183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician