Provider Demographics
NPI:1609257401
Name:TERHUNE, TAMREN JADE (MS, PLD)
Entity Type:Individual
Prefix:
First Name:TAMREN
Middle Name:JADE
Last Name:TERHUNE
Suffix:
Gender:F
Credentials:MS, PLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 831
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-0831
Mailing Address - Country:US
Mailing Address - Phone:806-228-6781
Mailing Address - Fax:
Practice Address - Street 1:5 S. INDUSTRIAL
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070
Practice Address - Country:US
Practice Address - Phone:806-228-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX#DT83768133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered