Provider Demographics
NPI:1497710677
Name:TURUNG, KIMBERLEY A (CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:A
Last Name:TURUNG
Suffix:
Gender:F
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:PO BOX 8792
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-8792
Mailing Address - Country:US
Mailing Address - Phone:440-871-5100
Mailing Address - Fax:440-871-5610
Practice Address - Street 1:2001 CROCKER RD STE 600
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6972
Practice Address - Country:US
Practice Address - Phone:440-871-5100
Practice Address - Fax:440-871-5610
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02303-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9283501Medicaid
OHP26491Medicare UPIN