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General NPI Number Information
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NPI Number | 1669062899
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Entity Type | Organization
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Legal Business Name | DAVID C TERRELL JR ARNP, PA
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 4289 NW AMERICAN LANE
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City | LAKE CITY
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State | FL
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Zip | 32055
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Country | US
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Telephone | 386-288-2884
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Fax |
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Provider Business Mailing Address
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Address Line | 4289 NW AMERICAN LN
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City | LAKE CITY
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State | FL
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Zip | 32055-4881
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Country | US
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Telephone | 386-287-2111
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Fax | 386-406-8368
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Authorized Official
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Title or Position | ARNP
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Name | DAVID CHARLES TERRELL
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Credential | ARNP
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Telephone | 386-287-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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