Individual
TERRI LYNN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-BC
Contact information
Practice address
800 WEST AVE S, LA CROSSE, WI 54601
(715) 838-3635
Mailing address
800 WEST AVE S, LA CROSSE, WI 54601-8806
(715) 838-3635
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
170833
WI
363LF0000X
Family Nurse Practitioner
R 183302-7
MN
Other
Enumeration date
02/14/2012
Last updated
10/17/2018
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