Provider Demographics
NPI:1598425464
Name:PLUNK, TERRY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:PLUNK
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COUNTY ROAD 472
Mailing Address - Street 2:
Mailing Address - City:RIENZI
Mailing Address - State:MS
Mailing Address - Zip Code:38865-9585
Mailing Address - Country:US
Mailing Address - Phone:662-415-8419
Mailing Address - Fax:
Practice Address - Street 1:611 ALCORN DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9388
Practice Address - Country:US
Practice Address - Phone:662-293-7677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPLUN-3NRJ5C363LF0000X
MS874737163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily