Provider Demographics
NPI:1346329612
Name:TERRY, SUZANNE J (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:J
Last Name:TERRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 RIVERWAY PL
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6763
Mailing Address - Country:US
Mailing Address - Phone:603-668-8400
Mailing Address - Fax:603-629-9346
Practice Address - Street 1:201 RIVERWAY PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6763
Practice Address - Country:US
Practice Address - Phone:603-668-8400
Practice Address - Fax:603-629-9346
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH037601-23-04363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30346186Medicaid
Q73388Medicare UPIN
NH30346186Medicaid