Healthcare Provider Details

I. General information

NPI: 1851245443
Provider Name (Legal Business Name): TERISSA HUGHES WATKINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 KENT ST
ALAMO GA
30411-4211
US

IV. Provider business mailing address

89 TELFAIR AVE
MC RAE HELENA GA
31055-4818
US

V. Phone/Fax

Practice location:
  • Phone: 912-568-7161
  • Fax: 912-568-7770
Mailing address:
  • Phone: 229-868-7404
  • Fax: 229-868-7245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN303829
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: