Provider Demographics
NPI:1922524644
Name:TERRY, ELIZABETH HOPE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:HOPE
Last Name:TERRY
Suffix:
Gender:F
Credentials:APRN, FNP-BC
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 130549
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713-0549
Mailing Address - Country:US
Mailing Address - Phone:903-579-3931
Mailing Address - Fax:903-509-5835
Practice Address - Street 1:700 OLYMPIC PLAZA CIR STE 420
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1952
Practice Address - Country:US
Practice Address - Phone:903-531-8950
Practice Address - Fax:903-531-8964
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134570363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP134570OtherAPRN LICENSE
TX730885OtherRN LICENSE