Provider Demographics
NPI:1639109747
Name:HILGER, TERRY SURMA (PSYMH NPC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:SURMA
Last Name:HILGER
Suffix:
Gender:F
Credentials:PSYMH NPC
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:LEE
Other - Last Name:SURMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2032
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302-2032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 WEST ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3548
Practice Address - Country:US
Practice Address - Phone:603-225-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH071618-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS55991Medicare UPIN
AZ112539Medicare PIN
AZ431544Medicaid
AZRN054601OtherNURSING LICENSE
AZ112540Medicare PIN
MS0404715OtherDRUG ENFORCEMENT AGENCY #