Provider Demographics
NPI:1689284945
Name:TERFEHR, MCKENZIE (NP)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:TERFEHR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 200TH AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-5080
Mailing Address - Country:US
Mailing Address - Phone:507-399-1604
Mailing Address - Fax:
Practice Address - Street 1:1235 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4461
Practice Address - Country:US
Practice Address - Phone:507-399-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA160167363LF0000X
MN7580363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily