Provider Demographics
NPI:1003997511
Name:TERZINI, SHERYL ANN (CNS)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:TERZINI
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7250 CLEARVISTA DRIVE
Practice Address - Street 2:SUITE 227
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5600
Practice Address - Country:US
Practice Address - Phone:317-621-7804
Practice Address - Fax:317-621-7275
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70000052A364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200944170Medicaid
INP01191781OtherRR MEDICARE PTAN
IN265570BMedicare UPIN
IN165490031Medicare PIN
IN200944170Medicaid