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General NPI Number Information
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NPI Number | 1205380946
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Entity Type | Individual
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Provider Name | WENDY TERRELL NP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 7120 CLEARVISTA DR STE 4000
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-1621
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Country | US
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Telephone | 317-621-7120
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Fax | 317-355-1505
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2805
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Country | US
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Telephone |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 71006604A
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License Number State | IN
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