Basic Information
| Provider Information | |||||||||
| NPI: | 1073522058 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYRD | ||||||||
| FirstName: | TERRILL | ||||||||
| MiddleName: | MARSH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | GNP BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 NW 91ST ST | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326071393 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643139249 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 SW ARCHER ROAD | ||||||||
| Address2: | MALCOM RANDALL VAMC | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523761611 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 09/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 75 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.