Bax, Terry L

Bax, Terry L is an sole proprietor health care provider with primary practice located at 421 Se Alfred Markham St , Lake City FL 32025-2204. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Bax, Terry L can be contacted via phone (386) 697-1364.

Contact Information

Primary practice address
421 Se Alfred Markham St Lake City FL 32025-2204
Phone: (386) 697-1364
Fax: (888) 370-3379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP3002322 Florida

Profile Details

NPI number 1154315612
LBN Legal business name Bax, Terry L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2005
Last updated Feb 2nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154315612 NPPES
Florida MEDICAID 301528900
Florida Other G1977

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