Provider Demographics
NPI:1962940460
Name:TURK, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:TURK
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 1:48 BOE LN
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MT
Mailing Address - Zip Code:59759-9702
Mailing Address - Country:US
Mailing Address - Phone:406-498-6183
Mailing Address - Fax:406-782-4020
Practice Address - Street 1:48 BOE LN
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MT
Practice Address - Zip Code:59759-9702
Practice Address - Country:US
Practice Address - Phone:406-498-6183
Practice Address - Fax:406-782-4020
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT124046363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health