Provider Demographics
NPI:1093497984
Name:TERRY, DENISE (STNA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2330 W GALBRAITH RD APT 29
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-4357
Mailing Address - Country:US
Mailing Address - Phone:513-295-4019
Mailing Address - Fax:
Practice Address - Street 1:2330 W GALBRAITH RD APT 29
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-4357
Practice Address - Country:US
Practice Address - Phone:513-295-4019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374067661294376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide