Provider Demographics
NPI:1275003519
Name:PEERCY, TEREZA J (APRN)
Entity Type:Individual
Prefix:
First Name:TEREZA
Middle Name:J
Last Name:PEERCY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 EVERGREEN RD # 108
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1010
Mailing Address - Country:US
Mailing Address - Phone:502-777-0203
Mailing Address - Fax:
Practice Address - Street 1:350 EVERGREEN RD # 108
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1010
Practice Address - Country:US
Practice Address - Phone:502-777-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012837363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health