Provider Demographics
NPI:1275567307
Name:WITHERINGTON, TERRY LYNN (APN)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNN
Last Name:WITHERINGTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 INDIAN LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6214
Mailing Address - Country:US
Mailing Address - Phone:615-826-3100
Mailing Address - Fax:615-447-1060
Practice Address - Street 1:107 GLEN OAK BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3162
Practice Address - Country:US
Practice Address - Phone:615-822-2400
Practice Address - Fax:615-822-9641
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN89426363L00000X
TNAPN0000006608363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q44478Medicare UPIN
TN484414Medicare UPIN
3906026Medicare ID - Type Unspecified
TN39060261Medicare PIN