Provider Demographics
NPI:1801524434
Name:SEWELL, TERRI (RN)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:SEWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1549
Mailing Address - Country:US
Mailing Address - Phone:850-708-3104
Mailing Address - Fax:770-723-8870
Practice Address - Street 1:221 VICTORIA LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30354-1549
Practice Address - Country:US
Practice Address - Phone:850-708-3104
Practice Address - Fax:770-723-8870
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN128832163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management