Basic Information
Provider Information
NPI: 1598725624
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAROW
FirstName: TERRI
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: NNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHARPENTIER
OtherFirstName: TERRI
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: NNP
OtherLastNameType: 1
Mailing Information
Address1: 475 WARNER AVE N
Address2:  
City: MAHTOMEDI
State: MN
PostalCode: 551152013
CountryCode: US
TelephoneNumber: 6512327031
FaxNumber:  
Practice Location
Address1: 1655 BEAM AVE
Address2: SUITE 302
City: MAPLEWOOD
State: MN
PostalCode: 551091163
CountryCode: US
TelephoneNumber: 6512327031
FaxNumber: 6512327826
Other Information
ProviderEnumerationDate: 03/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0000XR096246-5MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

No ID Information.


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