Provider Information for 1942833520
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SHANTELL TURNER
Sex: Female
NPI: 1942833520
Last Updated: 2023-10-10
Certification Date: 2023-10-10
Certification Date: 2023-10-10
Details
| Name | Value | ||||||||||||||||||||||||
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| NPI | 1942833520 | ||||||||||||||||||||||||
| Enumeration Date | 2020-02-21 | ||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||
| Mailing Address | 14497 POTOMAC MILLS RD # 1190 WOODBRIDGE, VA 22192-6807 United States Phone: 757-726-7180 | Fax: | ||||||||||||||||||||||||
| Primary Practice Address | 12934 HARBOR DR # 106 WOODBRIDGE, VA 22192-2930 United States Phone: 571-572-9179 | Fax:571-520-0614 | ||||||||||||||||||||||||
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