Provider Demographics
NPI:1609281070
Name:MCGUIRE, TERRA NICOLE (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:TERRA
Middle Name:NICOLE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:TERRA
Other - Middle Name:NICOLE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-FNP
Mailing Address - Street 1:2215 WILDWOOD AVE
Mailing Address - Street 2:#204
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-5089
Mailing Address - Country:US
Mailing Address - Phone:501-753-2424
Mailing Address - Fax:
Practice Address - Street 1:2215 WILDWOOD AVE
Practice Address - Street 2:#204
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-5089
Practice Address - Country:US
Practice Address - Phone:501-753-2424
Practice Address - Fax:501-753-2733
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily