Provider Demographics
NPI:1578631743
Name:TURNER, WENDY MICHELLE
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MICHELLE
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 1:276 DEAD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CREOLA
Mailing Address - State:AL
Mailing Address - Zip Code:36525-4406
Mailing Address - Country:US
Mailing Address - Phone:251-442-3144
Mailing Address - Fax:
Practice Address - Street 1:5565 HWY 43
Practice Address - Street 2:
Practice Address - City:SATSUMA
Practice Address - State:AL
Practice Address - Zip Code:36572
Practice Address - Country:US
Practice Address - Phone:251-675-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALT04656183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician