Healthcare Provider Details

I. General information

NPI: 1073422143
Provider Name (Legal Business Name): KELLY ANNE TERPIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SPRING GARDEN ST
GREENSBORO NC
27412-5015
US

IV. Provider business mailing address

2008 UPLAND LN
DURHAM NC
27712-2252
US

V. Phone/Fax

Practice location:
  • Phone: 336-334-5000
  • Fax:
Mailing address:
  • Phone: 678-628-9868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: