Individual
KOURTNEY MARIE TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
128 MINER RD, AVILLA, IN 46710-9690
(260) 226-0388
Mailing address
128 MINER RD, AVILLA, IN 46710-9690
(260) 226-0388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F10201135
IN
Other
Enumeration date
10/21/2020
Last updated
10/14/2022
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