SAMUEL TERRANOVA NP NPI 1154201689

NPI Information

  • NPI: 1154201689
  • Provider Name: SAMUEL TERRANOVA, NP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 770 KENMOOR AVE SE STE 100
    GRAND RAPIDS, MI
    ZIP 49546
  • Phone: (800) 865-4098

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NPI Details

Samuel Terranova, NP is a primary care nurse practitioner in Grand Rapids, MI. Samuel Terranova, NP NPI is 1154201689. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI
ZIP 49546-602
Phone: (800) 865-4098

The enumeration date for this NPI number is 9/4/2025 and was last updated on 9/4/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary Care4704356674MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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