Provider Demographics
NPI:1568135754
Name:TURNER, JANSEN LORRAINE SIA LLORICO (PMHNP)
Entity type:Individual
Prefix:
First Name:JANSEN LORRAINE
Middle Name:SIA LLORICO
Last Name:TURNER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:JANSEN LORRAINE
Other - Middle Name:SIA
Other - Last Name:LLORICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CROWNE POINT PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-5427
Mailing Address - Country:US
Mailing Address - Phone:513-743-7628
Mailing Address - Fax:
Practice Address - Street 1:18707 HARDY OAK BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4792
Practice Address - Country:US
Practice Address - Phone:512-610-8067
Practice Address - Fax:817-783-4672
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN478812163W00000X
OHAPRN.CNP.003530363L00000X
TX1158668363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse