Provider Demographics
NPI:1528213899
Name:MCNABB, TERRIE ALICE (BSN,RN)
Entity Type:Individual
Prefix:
First Name:TERRIE
Middle Name:ALICE
Last Name:MCNABB
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 WILLOW WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-6651
Mailing Address - Country:US
Mailing Address - Phone:901-358-7996
Mailing Address - Fax:
Practice Address - Street 1:2245 WILLOW WOOD AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-6651
Practice Address - Country:US
Practice Address - Phone:901-358-7996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000158851163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse