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General NPI Number Information
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NPI Number | 1053908780
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Entity Type | Individual
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Provider Name | TERINEI LOREL ANDREWS REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 3450 HIGHWAY 80 W
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City | JACKSON
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State | MS
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Zip | 39209-7201
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Country | US
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Telephone | 601-321-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 5155 KEELE ST APT 9B
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City | JACKSON
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State | MS
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Zip | 39206-4327
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Country | US
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Telephone | 769-230-6800
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Fax |
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 904851
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License Number State | MS
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