Basic Information
| Provider Information | |||||||||
| NPI: | 1316116049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURLEY | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | MS APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 270 MOHEGAN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW LONDON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063204125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604392275 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 270 MOHEGAN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW LONDON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063204125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604392275 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2008 | ||||||||
| LastUpdateDate: | 06/09/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 002574 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LS0200X | 002574 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | School |
No ID Information.