| Organization Name: | TERRELL CLINIC LLC |
| NPI Number: | 1053581744 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RENEA NAGEL TERRELL (OWNER) |
| Mailing Address: | 701 East Reelfoot Ave Suite 100 Union City |
| State: | TN US |
| Postal Code: | 38261 |
| Phone Number: | 7318859687 |
| Fax Number: | 7318856643 |
| NPI Enumeration Date: | 03/10/2008 |
| NPI Last Update Date: | 12/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | APN6675 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |