Provider Demographics
NPI:1003334889
Name:TURUCK, STEPHANIE T (LPN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:T
Last Name:TURUCK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SANDPIPER TRL SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5712
Mailing Address - Country:US
Mailing Address - Phone:330-770-0645
Mailing Address - Fax:
Practice Address - Street 1:1900 SANDPIPER TRL SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5712
Practice Address - Country:US
Practice Address - Phone:330-770-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH159820-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse