Healthcare Provider Details

I. General information

NPI: 1932072204
Provider Name (Legal Business Name): TERICA ADKISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6883 US HIGHWAY 90 STE 108
DAPHNE AL
36526-9611
US

IV. Provider business mailing address

6883 US HIGHWAY 90 STE 108
DAPHNE AL
36526-9611
US

V. Phone/Fax

Practice location:
  • Phone: 251-318-2601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-178701
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: