Provider Demographics
NPI:1669515615
Name:TURBYFILL, LARRY RUSS (REGISTERED NURSE)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:RUSS
Last Name:TURBYFILL
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:895 STATE FARM RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-264-9007
Mailing Address - Fax:828-262-5687
Practice Address - Street 1:221 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9723
Practice Address - Country:US
Practice Address - Phone:336-246-4542
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC125159163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse