Provider Demographics
NPI:1386153898
Name:MILLHOLLON-TURNER, JOHN LEONARD (PH D, RN)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEONARD
Last Name:MILLHOLLON-TURNER
Suffix:
Gender:M
Credentials:PH D, RN
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:LEONARD
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:FOREST FALLS
Mailing Address - State:CA
Mailing Address - Zip Code:92339-0058
Mailing Address - Country:US
Mailing Address - Phone:909-556-8011
Mailing Address - Fax:909-794-6978
Practice Address - Street 1:41134 PINE DR
Practice Address - Street 2:# 58
Practice Address - City:FOREST FALLS
Practice Address - State:CA
Practice Address - Zip Code:92339-0058
Practice Address - Country:US
Practice Address - Phone:909-556-8011
Practice Address - Fax:909-556-8011
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307691163W00000X, 163WH1000X, 163WM0705X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA307691OtherREGISTERED NURSE