Provider Demographics
NPI:1962083113
Name:TERRELL, KIARA MARDRA (APRN)
Entity type:Individual
Prefix:MS
First Name:KIARA
Middle Name:MARDRA
Last Name:TERRELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15203 BELLFIELD GROVE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4978
Mailing Address - Country:US
Mailing Address - Phone:713-259-0164
Mailing Address - Fax:
Practice Address - Street 1:18980 N MEMORIAL DR STE 240
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4498
Practice Address - Country:US
Practice Address - Phone:713-904-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1008930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty