Provider Demographics
NPI:1255946844
Name:TURNBULL, SUSAN
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:TURNBULL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 HEARTHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2295
Mailing Address - Country:US
Mailing Address - Phone:740-369-1171
Mailing Address - Fax:
Practice Address - Street 1:314 HEARTHSTONE DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2295
Practice Address - Country:US
Practice Address - Phone:740-369-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2107339Medicaid