Provider Demographics
NPI:1134881758
Name:TURAY, MARIATU KASIM
Entity type:Individual
Prefix:
First Name:MARIATU
Middle Name:KASIM
Last Name:TURAY
Suffix:
Gender:
Credentials:
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 639295
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9295
Mailing Address - Country:US
Mailing Address - Phone:571-642-3433
Mailing Address - Fax:855-998-8571
Practice Address - Street 1:6225 BRANDON AVE STE 365
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2526
Practice Address - Country:US
Practice Address - Phone:571-642-3433
Practice Address - Fax:855-998-8571
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182732363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024182732OtherDEPARTMENT OF HEALTH PROFESSIONS