Provider Demographics
NPI:1245390194
Name:FITZGERALD, TERRY LYNN (BS MBA HEALTHCARE MG)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LYNN
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:BS MBA HEALTHCARE MG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 WINCHESTER
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-9007
Mailing Address - Country:US
Mailing Address - Phone:901-369-1400
Mailing Address - Fax:901-369-1433
Practice Address - Street 1:3810 WINCHESTER
Practice Address - Street 2:SOUTH EAST MENTAL HEALTH CENTER
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-9007
Practice Address - Country:US
Practice Address - Phone:901-369-1400
Practice Address - Fax:901-369-1433
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator