Basic Information
| Provider Information | |||||||||
| NPI: | 1891815106 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAIRE | ||||||||
| FirstName: | TERRIEST | ||||||||
| MiddleName: | VONCEILE | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1844 | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371741844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152248066 | ||||||||
| FaxNumber: | 8887940549 | ||||||||
| Practice Location | |||||||||
| Address1: | 1032 MCCALLIE AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374032800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232664588 | ||||||||
| FaxNumber: | 8653420103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 677957 | CA | N | Nursing Service Providers | Registered Nurse | 163W00000X | RN178773 | TN | N | Nursing Service Providers | Registered Nurse | 363LF0000X | APN20009 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.