Provider Demographics
NPI:1366135576
Name:DULIN, TERRY M
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:M
Last Name:DULIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THERESE
Other - Middle Name:M
Other - Last Name:PEARMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9392 SHELBY LN
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-9458
Mailing Address - Country:US
Mailing Address - Phone:219-712-0507
Mailing Address - Fax:
Practice Address - Street 1:9392 SHELBY LN
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-9458
Practice Address - Country:US
Practice Address - Phone:219-712-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker