Provider Demographics
NPI:1467685651
Name:SHURTLEFF, TERRI ANN (CRT RCP)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:ANN
Last Name:SHURTLEFF
Suffix:
Gender:F
Credentials:CRT RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8212 ITHACA AVE STE EG
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2671
Mailing Address - Country:US
Mailing Address - Phone:806-792-8727
Mailing Address - Fax:806-792-8786
Practice Address - Street 1:212 S 1ST ST
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-4410
Practice Address - Country:US
Practice Address - Phone:806-637-3663
Practice Address - Fax:806-792-8786
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000085332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies