Provider Demographics
NPI:1740293026
Name:TERRANOVA, MARY CAROLINE (CNM)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:CAROLINE
Last Name:TERRANOVA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:777 LOWNDES HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2101
Mailing Address - Country:US
Mailing Address - Phone:800-967-2289
Mailing Address - Fax:
Practice Address - Street 1:4320 DIPLOMACY DR
Practice Address - Street 2:ATTN: SHERRY REEDY
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5925
Practice Address - Country:US
Practice Address - Phone:907-729-3971
Practice Address - Fax:907-729-1542
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP111307367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP0117Medicaid
AK8EB607Medicare ID - Type Unspecified