Provider Demographics
NPI:1871593905
Name:TURNAGE, LORNA A (NP)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:A
Last Name:TURNAGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGEVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63873-1401
Mailing Address - Country:US
Mailing Address - Phone:573-379-2100
Mailing Address - Fax:573-379-2101
Practice Address - Street 1:203 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PORTAGEVILLE
Practice Address - State:MO
Practice Address - Zip Code:63873-1401
Practice Address - Country:US
Practice Address - Phone:573-379-2100
Practice Address - Fax:573-379-2101
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112386363L00000X
261QR1300X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO189064OtherBCBS
MO424665644Medicaid
MO820614210OtherMEDICARE ID
MO189064OtherBCBS
Q17170Medicare UPIN