Provider Demographics
NPI:1669154498
Name:TURNER, TONYETTA MARIE
Entity type:Individual
Prefix:
First Name:TONYETTA
Middle Name:MARIE
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 WESTBROOK DR APT 412
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-1257
Mailing Address - Country:US
Mailing Address - Phone:216-309-8636
Mailing Address - Fax:
Practice Address - Street 1:4100 WESTBROOK DR APT 412
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-1257
Practice Address - Country:US
Practice Address - Phone:216-309-8636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker