Provider Demographics
NPI:1578543815
Name:TERRY, KAREN L (CNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:TERRY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:CHRISTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:578 N LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1131
Mailing Address - Country:US
Mailing Address - Phone:440-988-5234
Mailing Address - Fax:440-988-5269
Practice Address - Street 1:578 N LEAVITT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1131
Practice Address - Country:US
Practice Address - Phone:440-988-5234
Practice Address - Fax:440-988-5269
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-05992363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1578543815OtherNPI
OH2223294Medicaid