Provider Demographics
NPI:1467018309
Name:TURBIN, VITALIY (CNP)
Entity Type:Individual
Prefix:
First Name:VITALIY
Middle Name:
Last Name:TURBIN
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 N MORELAND BLVD APT 17
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1400
Mailing Address - Country:US
Mailing Address - Phone:216-556-1626
Mailing Address - Fax:
Practice Address - Street 1:2601 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0427
Practice Address - Country:US
Practice Address - Phone:702-233-4950
Practice Address - Fax:702-473-7158
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV819187363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner