MEDICARE: TERRY L EVERS APNP

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	R171736-3	MN
2	363LF0000X	Family Nurse Practitioner	R-171736-3	MN
3	363LF0000X	Family Nurse Practitioner	R171736-3	MN
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11074-33	WI
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CNP104	MN

General Provider Information

NPI Number	:	1194042663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY L EVERS APNP

Provider Business Mailing Address
First Line	:	N4857 GUSK RD
Second Line	:
City	:	TAYLOR
State	:	WI
Zip	:	54659-7001
Country	:	US
Telephone Number	:	763-233-8127
Fax Number	:

Provider Business Practice Location Address
First Line	:	11334 86TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4528
Country	:	US
Telephone Number	:	763-233-8127
Fax Number	:

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

Provider Enumeration Date	:	04/23/2010
Last Update Date	:	05/15/2024

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