Provider Demographics
NPI:1477822005
Name:TERWILLIGER, MICHELLE FUREY (RN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:FUREY
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 ADDISON BACK RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:NY
Mailing Address - Zip Code:14801-9338
Mailing Address - Country:US
Mailing Address - Phone:607-359-4981
Mailing Address - Fax:
Practice Address - Street 1:908 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:TROUPSBURG
Practice Address - State:NY
Practice Address - Zip Code:14885
Practice Address - Country:US
Practice Address - Phone:607-525-6301
Practice Address - Fax:607-525-6309
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY502415163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse