Provider Demographics
NPI:1326222993
Name:GITTINGS, TERRI LYNN (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LYNN
Last Name:GITTINGS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 WINDISH DR
Mailing Address - Street 2:BRIDGEWAY INC
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401
Mailing Address - Country:US
Mailing Address - Phone:309-344-2323
Mailing Address - Fax:
Practice Address - Street 1:INDUSTRIAL PARK ROAD
Practice Address - Street 2:BRIDGEWAY INC
Practice Address - City:MONMOUTH
Practice Address - State:IL
Practice Address - Zip Code:61462
Practice Address - Country:US
Practice Address - Phone:309-734-9461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse