Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | RN171345 NP | GA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN171345 NP | GA |
NPI | 1245675198 |
---|---|
Provider Name | Karen Jean Terrell |
First Address | Brunswick, GA 31520-6950 |
Second Address | Brunswick, GA 31520-6950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2013 |
Last Update Date | 14/05/2013 |