Provider Demographics
NPI:1881877876
Name:TURNER, LISA S (PA-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:S
Last Name:TURNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 NE DOCTORS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6324
Mailing Address - Country:US
Mailing Address - Phone:541-585-2400
Mailing Address - Fax:
Practice Address - Street 1:2275 NE DOCTORS DR STE 2
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6324
Practice Address - Country:US
Practice Address - Phone:541-585-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01315363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant