Basic Information
| Provider Information | |||||||||
| NPI: | 1114143112 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAXWELL | ||||||||
| FirstName: | TERRI | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 EQUESTRIAN DR | ||||||||
| Address2: | |||||||||
| City: | NEW HOPE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189385802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157942149 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1601 CHERRY ST | ||||||||
| Address2: | SUITE 1700 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191021321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152821600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 163W00000X | RN272614L | PA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.