Provider Demographics
NPI:1699575506
Name:JAMES, TERISE
Entity type:Individual
Prefix:
First Name:TERISE
Middle Name:
Last Name:JAMES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16107 WESTLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-6145
Mailing Address - Country:US
Mailing Address - Phone:734-961-2917
Mailing Address - Fax:
Practice Address - Street 1:16107 WESTLAKE CIR
Practice Address - Street 2:
Practice Address - City:VAN BUREN TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48111-6145
Practice Address - Country:US
Practice Address - Phone:734-961-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care