Provider Demographics
NPI:1306598495
Name:TURNER, SUZANNE MAE
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MAE
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 LAKE COWETA TRL
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-5932
Mailing Address - Country:US
Mailing Address - Phone:770-328-0560
Mailing Address - Fax:
Practice Address - Street 1:170 LAKE COWETA TRL
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5932
Practice Address - Country:US
Practice Address - Phone:770-328-0560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN259528163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse