Provider Demographics
NPI:1275330904
Name:TURNER, TIFFANY DAWN (PASTOR)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:DAWN
Last Name:TURNER
Suffix:
Gender:
Credentials:PASTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12943 N 68TH WEST AVE
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-6416
Mailing Address - Country:US
Mailing Address - Phone:918-797-4761
Mailing Address - Fax:
Practice Address - Street 1:12834 OLD US 169
Practice Address - Street 2:
Practice Address - City:OOLAGAH
Practice Address - State:OK
Practice Address - Zip Code:74053
Practice Address - Country:US
Practice Address - Phone:918-797-4761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral