Healthcare Provider Details

I. General information

NPI: 1316116049
Provider Name (Legal Business Name): SUSAN M. TURLEY MS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 11/18/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 EASTERN POINT RD MS 8200-10
GROTON CT
06340-5157
US

IV. Provider business mailing address

445 EASTERN POINT RD # MS 420010
GROTON CT
06340-5157
US

V. Phone/Fax

Practice location:
  • Phone: 860-414-4157
  • Fax: 860-441-6028
Mailing address:
  • Phone: 860-441-4157
  • Fax: 860-441-6028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number002574
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number002574
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number002574
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: