Provider Demographics
NPI:1245983584
Name:EUDY, TERRAH ROES (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:TERRAH
Middle Name:ROES
Last Name:EUDY
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MS
Other - First Name:TERRAH
Other - Middle Name:ROES
Other - Last Name:MCCOURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ADN
Mailing Address - Street 1:6847 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3929
Mailing Address - Country:US
Mailing Address - Phone:330-577-5881
Mailing Address - Fax:330-839-7937
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-577-5881
Practice Address - Fax:330-839-7937
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH312050163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse