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General NPI Number Information
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NPI Number | 1013420959
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Entity Type | Individual
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Provider Name | KRISTINE TERRELL
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Gender | Female
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 1958 STATE ROAD 44
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-8347
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Country | US
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Telephone | 386-423-9099
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Fax | 386-423-8265
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Provider Business Mailing Address
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Address Line | 215 SHUMAN BLVD STE 401
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City | NAPERVILLE
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State | IL
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Zip | 60563-8123
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Country | US
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Telephone | 630-303-5380
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Fax | 630-303-5385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5293
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License Number State | FL
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