Provider Demographics
NPI:1215781059
Name:TURENTINE, DAZHANE R
Entity type:Individual
Prefix:
First Name:DAZHANE
Middle Name:R
Last Name:TURENTINE
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 1:6035 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-6140
Mailing Address - Country:US
Mailing Address - Phone:317-590-7572
Mailing Address - Fax:
Practice Address - Street 1:10255 LONE WOLF DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-8250
Practice Address - Country:US
Practice Address - Phone:317-590-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide