=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700504065
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERRIN MORGAN GATHERS RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2022
-----------------------------------------------------
Last Update Date | 02/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 173 CHELSEA ST
-----------------------------------------------------
City | EVERETT
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02149-4632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-388-6200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 77 HAMPSTEAD RD
-----------------------------------------------------
City | JAMAICA PLAIN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02130-3912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-664-6060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | RN2340310
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WP0807X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | RN2340310
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------