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NPI Code Detail

MEDICARE: TERRI A. PETERSON-HENRY DO

MEDICARE: TERRI A. PETERSON-HENRY DO
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
1207Q00000XFamily Medicine Physician3555SD
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician3555SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376548800
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRI A. PETERSON-HENRY DO
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-4540
Fax Number : 605-328-4531
Provider Business Practice Location Address
First Line : 7220 W 41ST ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-6038
Country : US
Telephone Number : 605-328-9600
Fax Number : 605-328-9620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/25/2022

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Directions to “ TERRI A. PETERSON-HENRY DO” Practice Location

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