Provider Demographics
NPI:1538509997
Name:VERDIN, TERRY LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNN
Last Name:VERDIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 E BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3223
Mailing Address - Country:US
Mailing Address - Phone:864-720-1442
Mailing Address - Fax:864-720-1443
Practice Address - Street 1:793 E BUTLER RD
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-3223
Practice Address - Country:US
Practice Address - Phone:864-720-1442
Practice Address - Fax:864-720-1443
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2626Medicaid
SCSC23463641Medicare PIN