Provider Demographics
NPI:1548504525
Name:TERWILLIGER, JOANNE L
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:L
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 ROUTE 9P
Mailing Address - Street 2:APT 6
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6492
Mailing Address - Country:US
Mailing Address - Phone:518-596-9988
Mailing Address - Fax:
Practice Address - Street 1:559 ROUTE 9P
Practice Address - Street 2:APT 6
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6492
Practice Address - Country:US
Practice Address - Phone:518-596-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109353-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse