Provider Demographics
NPI:1205209681
Name:TERRY, JANINE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MRB IV RM 1030C
Mailing Address - Street 2:CAMPUS BOX 0252
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0001
Mailing Address - Country:US
Mailing Address - Phone:615-343-8553
Mailing Address - Fax:
Practice Address - Street 1:MRB IV RM 1030C
Practice Address - Street 2:CAMPUS BOX 0252
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-343-8553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9580522-4405363LA2100X
TN0000021714363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care