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NPI Code Detail

MEDICARE: TERA PRICE

MEDICARE:   TERA  PRICE
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner76916KS

General Provider Information

NPI Number : 1851769939
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERA PRICE
Provider Business Mailing Address
First Line : 524 N MAIN ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-2024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 524 N MAIN ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-2024
Country : US
Telephone Number : 316-321-6036
Fax Number : 316-321-6336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2015
Last Update Date : 09/08/2015

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Directions to “ TERA PRICE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.