Healthcare Provider Details

I. General information

NPI: 1992986186
Provider Name (Legal Business Name): TERRIE ZIEGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRIE JORDAN

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 03/04/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HOSPITAL RD
FT EISENHOWER GA
30905-5741
US

IV. Provider business mailing address

300 W HOSPITAL RD
FORT EISENHOWER GA
30905-5741
US

V. Phone/Fax

Practice location:
  • Phone: 706-787-2675
  • Fax:
Mailing address:
  • Phone: 706-787-2675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number8266
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD001735
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: