Provider Demographics
NPI:1134779648
Name:TURSKI, SHELLEY ANN (RD)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANN
Last Name:TURSKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:ANN
Other - Last Name:OPREMCAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3619 MIDLAND ST
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2524
Mailing Address - Country:US
Mailing Address - Phone:614-800-6884
Mailing Address - Fax:866-274-8373
Practice Address - Street 1:3619 MIDLAND ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2524
Practice Address - Country:US
Practice Address - Phone:614-800-6884
Practice Address - Fax:866-274-8373
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.08326133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0393785Medicaid
OH84-3633845OtherTAX ID
H765810OtherMEDICARE