Provider Demographics
NPI:1710343181
Name:MASSEY, TERI (RN, MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 CENTENNIAL WAY
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-9277
Mailing Address - Country:US
Mailing Address - Phone:800-592-2974
Mailing Address - Fax:
Practice Address - Street 1:825 CENTENNIAL WAY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-9277
Practice Address - Country:US
Practice Address - Phone:800-592-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704291458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily