Provider Demographics
NPI:1427178599
Name:PEURA, TERRY JAY (CRNP)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:JAY
Last Name:PEURA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 S PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-7213
Mailing Address - Country:US
Mailing Address - Phone:610-874-4403
Mailing Address - Fax:
Practice Address - Street 1:795 E LANCASTER AVE STE 210
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1525
Practice Address - Country:US
Practice Address - Phone:215-254-6000
Practice Address - Fax:215-754-1705
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP004910D363LP0808X, 363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics