Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1-162997 | AL |
NPI | 1285388421 |
---|---|
Provider Name | Ryan E Terry |
First Address | Vestavia, AL 35243-2372 |
Second Address | Birmingham, AL 35209-6804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2022 |
Last Update Date | 07/02/2022 |