Provider Demographics
NPI:1225367402
Name:CHI, TERANCE
Entity type:Individual
Prefix:
First Name:TERANCE
Middle Name:
Last Name:CHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 SOUTHTOWNE DR APT D203
Mailing Address - Street 2:
Mailing Address - City:S MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-4145
Mailing Address - Country:US
Mailing Address - Phone:414-793-7189
Mailing Address - Fax:
Practice Address - Street 1:1672 S 9TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3426
Practice Address - Country:US
Practice Address - Phone:414-645-9711
Practice Address - Fax:414-645-9211
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9139363LF0000X
WI169893163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily