Healthcare Provider Details

I. General information

NPI: 1689653602
Provider Name (Legal Business Name): TERRIE SMITH CAUSLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 POINT REPLETE CIR
FORT BELVOIR VA
22060-7444
US

IV. Provider business mailing address

7150 POINT REPLETE CIR
FORT BELVOIR VA
22060-7444
US

V. Phone/Fax

Practice location:
  • Phone: 703-765-0560
  • Fax:
Mailing address:
  • Phone: 703-765-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number163WG0100X
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: