MEDICARE: MRS. SANDRA ELIZABETH TERRAZZINO APRN (FNP)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	585440	TX

General Provider Information

NPI Number	:	1144213349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA ELIZABETH TERRAZZINO APRN (FNP)

Provider Business Mailing Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-916-1312
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 ROGER BROOKE DR
Second Line	:	BROOKE ARMY MEDICAL CENTER
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4501
Country	:	US
Telephone Number	:	210-916-4457
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	12/17/2019

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