Individual
NINA TERTEROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DCW, PTT, PTA, CMT
Contact information
Practice address
4132 W GARDEN DR APT B, PHOENIX, AZ 85029-3833
(747) 232-8508
Mailing address
5156 W OLIVE AVE STE 306, GLENDALE, AZ 85302-4205
(747) 232-8508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
790251
CA
251E00000X
Home Health Agency
Primary
23100429
AZ
Other
Enumeration date
07/27/2020
Last updated
02/13/2021
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