Provider Demographics
NPI:1205551025
Name:TERRY, ELIZABETH (CNA)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 GLASER DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4112
Mailing Address - Country:US
Mailing Address - Phone:817-791-3150
Mailing Address - Fax:
Practice Address - Street 1:3544 GLASER DR
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4112
Practice Address - Country:US
Practice Address - Phone:817-791-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health