Provider Demographics
NPI:1144708884
Name:TURNER, PENNEY LEEANN
Entity type:Individual
Prefix:
First Name:PENNEY
Middle Name:LEEANN
Last Name:TURNER
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 1:764 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-1208
Mailing Address - Country:US
Mailing Address - Phone:631-894-8729
Mailing Address - Fax:
Practice Address - Street 1:201 GARDEN PL
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1505
Practice Address - Country:US
Practice Address - Phone:516-489-9607
Practice Address - Fax:519-486-8026
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321370164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse