Provider Demographics
NPI:1003632217
Name:TURNER, NICOLE (CADCA I)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:CADCA I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-8805
Mailing Address - Country:US
Mailing Address - Phone:270-831-0107
Mailing Address - Fax:
Practice Address - Street 1:513 UNIVERSITY BLVD.
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-5709
Practice Address - Country:US
Practice Address - Phone:270-831-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY281725261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care