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NPI Code Detail

MEDICARE: ANDREW TERRY RN

MEDICARE: ANDREW TERRY RN
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
1163W00000XRegistered Nurse041.518044IL

General Provider Information

NPI Number : 1447106273
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW TERRY RN
Provider Business Mailing Address
First Line : 222 FOREST PARK PL
Second Line :
City : OTTAWA
State : IL
Zip : 61350-1124
Country : US
Telephone Number : 815-830-0762
Fax Number :
Provider Business Practice Location Address
First Line : 1304 FRANKLIN AVE
Second Line :
City : NORMAL
State : IL
Zip : 61761-3558
Country : US
Telephone Number : 309-268-5488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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