Kelly, Terri Ellen

Kelly, Terri Ellen is an individual health care provider with primary practice located at 1421 N 7Th St , Terre Haute IN 47807-1005. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Kelly, Terri Ellen can be contacted via phone (812) 234-8261.

Contact Information

Primary practice address
1421 N 7Th St Terre Haute IN 47807-1005
Phone: (812) 234-8261
Fax: (812) 234-8262
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28170574A Indiana

Profile Details

NPI number 1942330626
LBN Legal business name Kelly, Terri Ellen
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Mar 12th, 2008 - about 16 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 1942330626 NPPES
Indiana Other 000000508494 BLUE CROSS/BLUE SHIELD
Indiana MEDICAID 200853750 BLUE CROSS/BLUE SHIELD

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