Provider Demographics
NPI:1548741374
Name:WILLIAMS, TERRY CATCHINGS (NP-C)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:CATCHINGS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:LUSHELL
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:6105 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:MS
Mailing Address - Zip Code:39083-8927
Mailing Address - Country:US
Mailing Address - Phone:601-717-2024
Mailing Address - Fax:
Practice Address - Street 1:1007 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2603
Practice Address - Country:US
Practice Address - Phone:601-833-9388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily