Provider Demographics
NPI:1366216699
Name:PRETTY, TERRA LYNN (MA, CNA)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:LYNN
Last Name:PRETTY
Suffix:
Gender:F
Credentials:MA, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3201
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-0201
Mailing Address - Country:US
Mailing Address - Phone:484-554-0873
Mailing Address - Fax:
Practice Address - Street 1:136 FOUNDERS CT
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9529
Practice Address - Country:US
Practice Address - Phone:484-554-0873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA20061038251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care