Provider Demographics
NPI:1841038460
Name:TERRY, KRISTINE A (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:A
Last Name:TERRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27B TALISMAN DR # U-3
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-7913
Mailing Address - Country:US
Mailing Address - Phone:970-372-0456
Mailing Address - Fax:970-507-3010
Practice Address - Street 1:27B TALISMAN DR # U-3
Practice Address - Street 2:
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147-7913
Practice Address - Country:US
Practice Address - Phone:970-372-0456
Practice Address - Fax:970-507-3010
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0999960-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily