Provider Demographics
NPI:1215911847
Name:DEGEEST, TERRI L (CNM, OB GYN NP)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:L
Last Name:DEGEEST
Suffix:
Gender:F
Credentials:CNM, OB GYN NP
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:L
Other - Last Name:WYNN-HIPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:7104 CALAMAR DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5215
Mailing Address - Country:US
Mailing Address - Phone:910-867-1373
Mailing Address - Fax:
Practice Address - Street 1:WOMACK ARMY MEDICAL CTR
Practice Address - Street 2:2817 REILLY ROAD
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-7994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCNM- 359176B00000X
NYF360483-1363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC176B00000XOtherTAXONOMY CODE