Individual
STEPHANIE TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1668 W PEACE ST, CANTON, MS 39046-5332
(601) 859-5213
(601) 859-8771
Mailing address
PO BOX 588, CANTON, MS 39046-0588
(601) 859-5213
(601) 859-8771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R866603
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R866603
LICENSE NUMBER
MS
Enumeration date
08/01/2008
Last updated
06/15/2022
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