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Individual

MRS. TERA KAY WALDROUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, APN, PMHNP

Contact information

Practice address
94 MAIN ST, HYANNIS, MA 02601-3146
(508) 771-9599
(508) 771-1208
Mailing address
224 PATRIOT WAY, CENTERVILLE, MA 02632-1514
(214) 718-0543

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
751298
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2278241
MA

Other

Enumeration date
02/16/2012
Last updated
12/30/2012
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