Provider Demographics
NPI:1841859113
Name:PEERENBOOM, TERRI (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:PEERENBOOM
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:LYNNE
Other - Last Name:BAIZE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 799
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77549-0799
Mailing Address - Country:US
Mailing Address - Phone:281-993-3733
Mailing Address - Fax:
Practice Address - Street 1:2222 GREENHOUSE RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7288
Practice Address - Country:US
Practice Address - Phone:281-993-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139890363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health