Provider Demographics
NPI:1114774957
Name:TURNER, BIANCKA LATASHA
Entity type:Individual
Prefix:
First Name:BIANCKA
Middle Name:LATASHA
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 1:535 GRISWOLD ST # 111-508
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-3604
Mailing Address - Country:US
Mailing Address - Phone:248-870-8222
Mailing Address - Fax:
Practice Address - Street 1:535 GRISWOLD ST # 111-508
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3604
Practice Address - Country:US
Practice Address - Phone:248-870-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide