Provider Demographics
NPI:1720276157
Name:GEARHART, TERA LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TERA
Middle Name:LYNN
Last Name:GEARHART
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 1:7344 LANDMARK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-6355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:926 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3614
Practice Address - Country:US
Practice Address - Phone:615-436-9060
Practice Address - Fax:615-235-9725
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN296224163W00000X
MD17301-NP363L00000X
IAH171811363L00000X
TN32674363L00000X
FLAPRN11001257363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
4DV11OtherFL BCBS
TNQ079416Medicaid
KS30004877210001Medicaid
IA0135454Medicaid
OH0231962Medicaid
FL102419500Medicaid
4DV11OtherFL BCBS