Provider Demographics
NPI:1255038568
Name:TERRY, KELSIE ELIZABETH
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:ELIZABETH
Last Name:TERRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7506 SW DELTA AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6417
Mailing Address - Country:US
Mailing Address - Phone:405-567-5114
Mailing Address - Fax:
Practice Address - Street 1:4657 SE BRIGHTON DR
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-6652
Practice Address - Country:US
Practice Address - Phone:405-567-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula