Provider Demographics
NPI:1609012590
Name:TURNER, LASHONDA TIYON (CRNA)
Entity type:Individual
Prefix:MRS
First Name:LASHONDA
Middle Name:TIYON
Last Name:TURNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 18TH ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-2066
Mailing Address - Country:US
Mailing Address - Phone:225-772-2270
Mailing Address - Fax:
Practice Address - Street 1:3663 WOODWARD AVE
Practice Address - Street 2:200
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2445
Practice Address - Country:US
Practice Address - Phone:313-993-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710940367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89774UOtherBCBS
TX199856901Medicaid
TXP00686279OtherRAILROAD
TX89774UOtherBCBS