Provider Demographics
NPI:1235546656
Name:AHRENS, TERI L (FNP-C)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:L
Last Name:AHRENS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 W HALF MOON LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-4374
Mailing Address - Country:US
Mailing Address - Phone:208-866-8483
Mailing Address - Fax:208-321-7052
Practice Address - Street 1:8 6TH ST N STE 200
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-5095
Practice Address - Country:US
Practice Address - Phone:208-467-7423
Practice Address - Fax:208-475-6038
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1453A364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health