Provider Demographics
NPI:1841886942
Name:TERRACE, DONALD (FNP-BC)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:TERRACE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:
Other - Last Name:TERRACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:787 S METCALF ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-1030
Mailing Address - Country:US
Mailing Address - Phone:619-847-4758
Mailing Address - Fax:
Practice Address - Street 1:787 S METCALF ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1030
Practice Address - Country:US
Practice Address - Phone:619-847-4758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027587363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner