Individual
HOLLY LYNE TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-9515
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28167280A
IN
363L00000X
Nurse Practitioner
Primary
71009575A
IN
Other
Enumeration date
06/11/2019
Last updated
04/20/2020
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