Provider Demographics
NPI:1245616705
Name:TERWILLIGER, KAREN JANET (MS, APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JANET
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:MS, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 OLD VOLUNTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GRISWOLD
Mailing Address - State:CT
Mailing Address - Zip Code:06351-8828
Mailing Address - Country:US
Mailing Address - Phone:401-497-6799
Mailing Address - Fax:
Practice Address - Street 1:3 HERON RD
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-3253
Practice Address - Country:US
Practice Address - Phone:401-497-6799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6220363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care