Terry, Mary

Terry, Mary is an individual health care provider with primary practice located at 2600 Greenbush St , Lafayette IN 47904-2477. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Terry, Mary can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2600 Greenbush St Lafayette IN 47904-2477
Phone: (765) 448-8000
Fax: (765) 448-7624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28177134A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71007565A Indiana

Profile Details

NPI number 1285164517
LBN Legal business name Terry, Mary
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2017
Last updated Nov 13th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285164517 NPPES
Indiana Other 000001121068 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 300007729 ANTHEM PROVIDER NUMBER

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