Provider Demographics
NPI:1497749980
Name:TERRELL, PAMELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:TERRELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 N BRIARWOOD LN
Mailing Address - Street 2:SUITE D
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5214
Mailing Address - Country:US
Mailing Address - Phone:765-282-4766
Mailing Address - Fax:
Practice Address - Street 1:3645 N BRIARWOOD LN
Practice Address - Street 2:SUITE D
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5214
Practice Address - Country:US
Practice Address - Phone:765-282-4766
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017361A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy