Provider Demographics
NPI:1194842419
Name:DUKE, TERRI A (NP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:A
Last Name:DUKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4680
Mailing Address - Country:US
Mailing Address - Phone:813-971-2424
Mailing Address - Fax:813-971-2420
Practice Address - Street 1:3000 MEDICAL PARK DR
Practice Address - Street 2:SUITE 500
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4680
Practice Address - Country:US
Practice Address - Phone:813-971-2424
Practice Address - Fax:813-971-2420
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2530572363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP68822Medicare UPIN