Provider Demographics
NPI:1235325341
Name:TERRY, LYNDA F (PA-C)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:F
Last Name:TERRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 940
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-0940
Mailing Address - Country:US
Mailing Address - Phone:304-466-2944
Mailing Address - Fax:304-466-2943
Practice Address - Street 1:1500 TERRACE STREET
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-0940
Practice Address - Country:US
Practice Address - Phone:304-466-2944
Practice Address - Fax:304-466-2943
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant