Healthcare Provider Details

I. General information

NPI: 1235742362
Provider Name (Legal Business Name): SUSAN TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 LEE ST
MOOREFIELD WV
26836-1012
US

IV. Provider business mailing address

27 ROME BEAUTY DR
PETERSBURG WV
26847-8797
US

V. Phone/Fax

Practice location:
  • Phone: 540-398-1826
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: