Individual
TERRY E PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
145 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-2195
(606) 256-3947
Mailing address
145 NEWCOMB AVE, MOUNT VERNON, KY 40456-2728
(606) 256-2195
(606) 256-3947
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1188A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323242
ANTHEM
KY
05
—
74399510
—
KY
Enumeration date
08/29/2006
Last updated
05/15/2018
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