Provider Demographics
NPI:1790751303
Name:TURNER, SUSAN K (CNM, NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:TURNER
Suffix:
Gender:F
Credentials:CNM, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 ADAMS ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1180
Mailing Address - Country:US
Mailing Address - Phone:707-968-2865
Mailing Address - Fax:707-963-9185
Practice Address - Street 1:821 SAINT HELENA HWY S
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-2266
Practice Address - Country:US
Practice Address - Phone:707-963-5006
Practice Address - Fax:707-963-5083
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNM930367A00000X
CANP5763363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP08647Medicare UPIN