Provider Demographics
NPI:1346801636
Name:LEFEVER, TERRI ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:TERRI ANNE
Middle Name:
Last Name:LEFEVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TERRI ANNE
Other - Middle Name:
Other - Last Name:WILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 WELLNESS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2156
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1184 STATE ROUTE 50
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1923
Practice Address - Country:US
Practice Address - Phone:518-384-1281
Practice Address - Fax:518-384-0321
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023919363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant