Provider Demographics
NPI:1952462491
Name:MARSDEN, TERRI YEVETTE (CRNA)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:YEVETTE
Last Name:MARSDEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WATER ELM DR
Mailing Address - Street 2:
Mailing Address - City:MAYLENE
Mailing Address - State:AL
Mailing Address - Zip Code:35114-4919
Mailing Address - Country:US
Mailing Address - Phone:205-664-2212
Mailing Address - Fax:
Practice Address - Street 1:119 WATER ELM DR
Practice Address - Street 2:
Practice Address - City:MAYLENE
Practice Address - State:AL
Practice Address - Zip Code:35114-4919
Practice Address - Country:US
Practice Address - Phone:205-664-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094661367500000X
DEL6-0A00626367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered