Provider Demographics
NPI:1114234838
Name:PARKIN, TERRI (RN, MS, FNP)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:
Last Name:PARKIN
Suffix:
Gender:F
Credentials:RN, MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COATES DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6758
Mailing Address - Country:US
Mailing Address - Phone:845-651-1400
Mailing Address - Fax:845-651-1512
Practice Address - Street 1:721 HOMESTEAD AVE
Practice Address - Street 2:
Practice Address - City:MAYBROOK
Practice Address - State:NY
Practice Address - Zip Code:12543-1307
Practice Address - Country:US
Practice Address - Phone:845-427-0884
Practice Address - Fax:845-427-9072
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily