Individual
MS. LAURA P TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3998 FAIR RIDGE DR., SUITE 320, FAIRFAX, VA 22033-2921
(703) 391-3129
(703) 295-9369
Mailing address
68 S SERVICE RD, STE 350, MELVILLE, NY 11747-2358
(516) 945-3107
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166846
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699869578
—
VA
01
—
484645
NCPPO
VA
01
—
K142-0002
CAREFIRST
DC
Enumeration date
10/03/2006
Last updated
10/31/2016
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