Provider Demographics
NPI:1447722533
Name:TERRY, TASHIA PALMORE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:TASHIA
Middle Name:PALMORE
Last Name:TERRY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116 SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-7864
Mailing Address - Country:US
Mailing Address - Phone:864-980-4212
Mailing Address - Fax:
Practice Address - Street 1:105 VINECREST CT # 510
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-8031
Practice Address - Country:US
Practice Address - Phone:864-725-4016
Practice Address - Fax:864-725-5839
Is Sole Proprietor?:No
Enumeration Date:2018-12-30
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22434363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner