Individual
LISA H TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
225 MEDICAL CENTER DR, SUITE 209B, PADUCAH, KY 42003-7914
(270) 441-4610
(270) 441-4608
Mailing address
4604 ORCHARD RD, METROPOLIS, IL 62960-4504
(618) 524-1740
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5324P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000545288
BLUE CROSS BLUE SHIELD
KY
Enumeration date
08/31/2007
Last updated
12/22/2010
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