Provider Demographics
NPI:1851818876
Name:MEHIGAN, TERRY NEIL (FNP)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:NEIL
Last Name:MEHIGAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 BROWN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2903
Mailing Address - Country:US
Mailing Address - Phone:574-215-4823
Mailing Address - Fax:
Practice Address - Street 1:3800 HOLLYWOOD RD STE 104
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-8511
Practice Address - Country:US
Practice Address - Phone:269-428-0819
Practice Address - Fax:269-428-0841
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704280228363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704280228OtherNURSE PRACTITIONER LICENSE