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General NPI Number Information
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NPI Number | 1750944773
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Entity Type | Individual
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Provider Name | TERRELL MESSERLY
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Gender | Male
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 515 22ND AVE
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City | MONROE
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State | WI
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Zip | 53566-1569
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Country | US
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Telephone | 608-324-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 750 OTTO AVE UNIT 2236
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City | SAINT PAUL
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State | MN
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Zip | 55102-5042
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Country | US
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Telephone | 775-304-7813
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 84435
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 84435
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License Number State | WI
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