Healthcare Provider Details

I. General information

NPI: 1780026385
Provider Name (Legal Business Name): TERRY JEAN NESMITH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRY JEAN CROWE RN

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 2ND ST
CRESSON PA
16630-1141
US

IV. Provider business mailing address

815 2ND ST
CRESSON PA
16630-1141
US

V. Phone/Fax

Practice location:
  • Phone: 724-874-1485
  • Fax:
Mailing address:
  • Phone: 724-874-1485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN573366
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN573366
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP021891
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP021891
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: