Provider Demographics
NPI:1366517807
Name:NEVINS, TERRY J (DO)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:J
Last Name:NEVINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-3413
Mailing Address - Country:US
Mailing Address - Phone:775-738-5850
Mailing Address - Fax:775-738-5856
Practice Address - Street 1:762 14TH ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-3413
Practice Address - Country:US
Practice Address - Phone:775-738-5850
Practice Address - Fax:775-738-5856
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20-8002094OtherTAX ID
NV26-0796883OtherTAX ID
NVV103603Medicare PIN
NV26-0796883OtherTAX ID