Gourley, Terry Lee

Gourley, Terry Lee is an individual health care provider with primary practice located at 2900 Doolittle Dr , Ellsworth Afb SD 57706-4821. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Gourley, Terry Lee can be contacted via phone (053) 853-2736.

Contact Information

Primary practice address
2900 Doolittle Dr Ellsworth Afb SD 57706-4821
Phone: (053) 853-2736
Fax: (308) 367-4164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 866 Nebraska

Profile Details

NPI number 1710014477
LBN Legal business name Gourley, Terry Lee
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2007
Last updated May 3rd, 2018 - about 7 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 1710014477 NPPES
Nebraska Other 866 LICENSE
Nebraska Other 1029358 LICENSE

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