Provider Demographics
NPI:1750501326
Name:DUNCAN, TERRI (FNP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:FNP
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 9
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37662-0009
Mailing Address - Country:US
Mailing Address - Phone:423-857-2093
Mailing Address - Fax:423-857-2012
Practice Address - Street 1:105 W STONE DR
Practice Address - Street 2:STE 1F
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3256
Practice Address - Country:US
Practice Address - Phone:423-230-2420
Practice Address - Fax:423-230-2421
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN96894163WE0003X
TN11970363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341427Medicaid
VA1750501326Medicaid
TN3341427Medicare PIN
TN0281780001Medicare PIN
TN103I086169Medicare UPIN
VA1750501326Medicaid
TN3700592Medicare PIN
VAC06181Medicare UPIN
TN0281780003Medicare PIN