Provider Demographics
NPI:1821299173
Name:PLATT, TERRIE H (CRNP)
Entity Type:Individual
Prefix:
First Name:TERRIE
Middle Name:H
Last Name:PLATT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TERRIE
Other - Middle Name:H
Other - Last Name:PLATT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:CHATOM
Mailing Address - State:AL
Mailing Address - Zip Code:36518-0031
Mailing Address - Country:US
Mailing Address - Phone:251-242-1422
Mailing Address - Fax:
Practice Address - Street 1:717 DOWNTOWNER LOOP W
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5503
Practice Address - Country:US
Practice Address - Phone:252-544-7077
Practice Address - Fax:251-342-8999
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-122685363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP59651Medicaid
AK152365Medicare PIN