Individual
MRS. DEBORAH TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5663 HIGHWAY 90, CLAIRFIELD, TN 37715-3632
(423) 784-6135
(423) 784-8615
Mailing address
PO BOX 540, JELLICO, TN 37762-0540
(423) 784-8492
(423) 784-8358
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 180
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511908
—
TN
01
—
180
STATE LICENSE
TN
05
—
95620076
—
KY
Enumeration date
05/27/2005
Last updated
03/07/2023
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