Individual
DEBORAH TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4554
(614) 722-4565
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4554
(614) 722-4565
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
COA03896
OH
363LP0200X
Pediatric Nurse Practitioner
RN169332NP03896
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2231169
—
OH
01
—
78012812
MEDICAID
KY
Enumeration date
10/10/2005
Last updated
02/04/2016
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