Provider Demographics
NPI:1194042663
Name:EVERS, TERRY L (APNP)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:EVERS
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N4857 GUSK RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:WI
Mailing Address - Zip Code:54659-7001
Mailing Address - Country:US
Mailing Address - Phone:763-233-8127
Mailing Address - Fax:
Practice Address - Street 1:11334 86TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4528
Practice Address - Country:US
Practice Address - Phone:763-233-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR171736-3163WP0808X, 363LF0000X
MNR-171736-3363LF0000X
WI11074-33363LP0808X
MNCNP104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily