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Individual

TERA PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
524 N MAIN ST, EL DORADO, KS 67042-2024
(316) 321-6036
(316) 321-6336
Mailing address
524 N MAIN ST, EL DORADO, KS 67042-2024

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
76916
KS

Other

Enumeration date
09/08/2015
Last updated
09/08/2015
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