Provider Demographics
NPI:1922313451
Name:TERRY, AMY CHRISTINA (NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHRISTINA
Last Name:TERRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROSE
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:239 MOUNTAIN PARKWAY SPUR
Mailing Address - Street 2:
Mailing Address - City:CAMPTON
Mailing Address - State:KY
Mailing Address - Zip Code:41301-8988
Mailing Address - Country:US
Mailing Address - Phone:606-668-6932
Mailing Address - Fax:606-668-3125
Practice Address - Street 1:239 MOUNTAIN PARKWAY SPUR
Practice Address - Street 2:
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301-8988
Practice Address - Country:US
Practice Address - Phone:606-668-6932
Practice Address - Fax:606-668-3125
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6558P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner