Provider Demographics
NPI:1841565728
Name:MILLER, TERRE D (FNP)
Entity Type:Individual
Prefix:
First Name:TERRE
Middle Name:D
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TERRE
Other - Middle Name:D
Other - Last Name:HIMMELREICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2605 FOREST HILLS RD SW STE D
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4448
Mailing Address - Country:US
Mailing Address - Phone:252-243-7161
Mailing Address - Fax:
Practice Address - Street 1:901 N WINSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8467
Practice Address - Country:US
Practice Address - Phone:252-937-0229
Practice Address - Fax:252-934-7310
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC000985363L00000X
NC5008890363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMM2602387OtherDEA
NC1841565728OtherNPI