Provider Demographics
NPI:1235840737
Name:POWELL, TERRI TEMPLIN (NP)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:TEMPLIN
Last Name:POWELL
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 1:2725 MATT CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8687
Mailing Address - Country:US
Mailing Address - Phone:317-966-9663
Mailing Address - Fax:
Practice Address - Street 1:17600 SHAMROCK BLVD STE 500B
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-7002
Practice Address - Country:US
Practice Address - Phone:317-867-5263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014162A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health