Provider Demographics
NPI:1447303235
Name:TERRY, NANCY JO (RN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JO
Last Name:TERRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:JO
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:15730 S AVENUE 5 E
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-8012
Mailing Address - Country:US
Mailing Address - Phone:928-726-4610
Mailing Address - Fax:928-726-6131
Practice Address - Street 1:15730 S AVENUE 5 E
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8012
Practice Address - Country:US
Practice Address - Phone:928-726-4610
Practice Address - Fax:928-726-6131
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN107130163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse