Provider Demographics
NPI:1407849193
Name:EDWARDS, TERRIE LYNN (ARNP)
Entity type:Individual
Prefix:MS
First Name:TERRIE
Middle Name:LYNN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N OWEN WALTERS BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:OK
Mailing Address - Zip Code:74365-5003
Mailing Address - Country:US
Mailing Address - Phone:918-434-8500
Mailing Address - Fax:918-434-5051
Practice Address - Street 1:900 N OWEN WALTERS BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:OK
Practice Address - Zip Code:74365-5003
Practice Address - Country:US
Practice Address - Phone:918-434-8500
Practice Address - Fax:918-434-5051
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0039078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKS99029Medicare UPIN