Provider Demographics
NPI:1508921438
Name:TERPSTRA, LINDA JEAN (CRNA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:TERPSTRA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:COPEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75121-0034
Mailing Address - Country:US
Mailing Address - Phone:972-843-2559
Mailing Address - Fax:
Practice Address - Street 1:1501 N REDBUD BLVD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3226
Practice Address - Country:US
Practice Address - Phone:972-548-0771
Practice Address - Fax:972-562-2300
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX443316367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered