Provider Demographics
NPI:1285949081
Name:TURNER, TIA L (RN)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:L
Last Name:TURNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 HILLSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3926
Mailing Address - Country:US
Mailing Address - Phone:937-830-5757
Mailing Address - Fax:
Practice Address - Street 1:1816 HILLSDALE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3926
Practice Address - Country:US
Practice Address - Phone:937-830-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH369234163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse