Provider Demographics
NPI:1407958036
Name:TERRERO, ROBIN G (DPH)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:G
Last Name:TERRERO
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 KEITH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3721
Mailing Address - Country:US
Mailing Address - Phone:423-476-4312
Mailing Address - Fax:423-476-7982
Practice Address - Street 1:3443 KEITH ST NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3721
Practice Address - Country:US
Practice Address - Phone:423-476-4312
Practice Address - Fax:423-476-7982
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist