Healthcare Provider Details

I. General information

NPI: 1497710677
Provider Name (Legal Business Name): KIMBERLEY A TURUNG CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CROCKER RD STE 600
WESTLAKE OH
44145-6972
US

IV. Provider business mailing address

PO BOX 8792
BELFAST ME
04915-8792
US

V. Phone/Fax

Practice location:
  • Phone: 440-871-5100
  • Fax: 440-871-5610
Mailing address:
  • Phone: 440-871-5100
  • Fax: 440-871-5610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number02303-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: