Healthcare Provider Details

I. General information

NPI: 1134305329
Provider Name (Legal Business Name): TERRI ALEJANDRO RN, BSN, PHN, HN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 N 3RD AVE
PHOENIX AZ
85013-4360
US

IV. Provider business mailing address

3141 N 3RD AVE
PHOENIX AZ
85013-4360
US

V. Phone/Fax

Practice location:
  • Phone: 866-267-1701
  • Fax: 888-785-3513
Mailing address:
  • Phone: 866-267-1701
  • Fax: 888-785-3513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN157679
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR 135268-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: