Provider Demographics
NPI:1679870182
Name:TURNER NURSING ANESTHESIA, INC, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:TURNER NURSING ANESTHESIA, INC, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:909-289-3255
Mailing Address - Street 1:121 LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4941
Mailing Address - Country:US
Mailing Address - Phone:909-289-3255
Mailing Address - Fax:909-307-0333
Practice Address - Street 1:121 LAKESIDE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4941
Practice Address - Country:US
Practice Address - Phone:909-289-3255
Practice Address - Fax:909-307-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2669367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty