Provider Demographics
NPI:1831784032
Name:CONNORS, TERRI LYNN
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:CONNORS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:FISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 N DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-1049
Mailing Address - Country:US
Mailing Address - Phone:608-768-6243
Mailing Address - Fax:608-524-6196
Practice Address - Street 1:2000 N DEWEY AVE
Practice Address - Street 2:
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-1049
Practice Address - Country:US
Practice Address - Phone:608-768-6243
Practice Address - Fax:608-524-6196
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
WI82347-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator