Healthcare Provider Details
I. General information
NPI: 1669147815
Provider Name (Legal Business Name): ELENA TUROVSKAYA APRN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
512 WEXFORD DR
HURON OH
44839-3000
US
IV. Provider business mailing address
512 WEXFORD DR
HURON OH
44839-3000
US
V. Phone/Fax
- Phone: 419-706-1607
- Fax:
- Phone: 419-706-1607
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0029488 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: