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General NPI Number Information
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NPI Number | 1295985703
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Entity Type | Individual
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Provider Name | TAMMY RENEE TERRELL
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Gender | Female
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 215 W GILLESPIE ST
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City | STARKVILLE
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State | MS
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Zip | 39759-3207
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Country | US
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Telephone | 662-418-5324
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Fax | 662-615-6161
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Provider Business Mailing Address
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Address Line | 711 1/2 WHITFIELD ST
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City | STARKVILLE
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State | MS
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Zip | 39759-3124
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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 | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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License Number | P323367
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License Number State | MS
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