Healthcare Provider Details

I. General information

NPI: 1821299173
Provider Name (Legal Business Name): TERRIE H PLATT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRIE H PLATT CRNP

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 DOWNTOWNER LOOP W
MOBILE AL
36609-5503
US

IV. Provider business mailing address

PO BOX 31
CHATOM AL
36518-0031
US

V. Phone/Fax

Practice location:
  • Phone: 252-544-7077
  • Fax: 251-342-8999
Mailing address:
  • Phone: 251-242-1422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number1-122685
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: