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General NPI Number Information
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NPI Number | 1366366163
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Entity Type | Individual
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Provider Name | MRS. KEANTAE TERRELL
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 575 HILL COUNTRY DR STE 202
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City | KERRVILLE
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State | TX
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Zip | 78028-6024
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Country | US
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Telephone | 830-258-6237
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Fax |
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Provider Business Mailing Address
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Address Line | 17938 AQUA HAVEN LN
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City | CONROE
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State | TX
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Zip | 77302-2258
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1138727
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License Number State | TX
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