Provider Demographics
NPI:1629009287
Name:TURBERVILLE-TRUJILLO, LINDA (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TURBERVILLE-TRUJILLO
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 1:1660 MULKEY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106
Mailing Address - Country:US
Mailing Address - Phone:678-460-2700
Mailing Address - Fax:770-739-0212
Practice Address - Street 1:1660 MULKEY RD
Practice Address - Street 2:SUITE B
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106
Practice Address - Country:US
Practice Address - Phone:678-460-2700
Practice Address - Fax:770-739-0212
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF1101172207RN0300X
GAR11428207RN0300X
GARN111428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology