Provider Demographics
NPI:1366908287
Name:CRAIG, TERRASEETA
Entity type:Individual
Prefix:MRS
First Name:TERRASEETA
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TERRASEETA
Other - Middle Name:
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:1528 DEERWOOD DR E
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618-3073
Mailing Address - Country:US
Mailing Address - Phone:251-422-1105
Mailing Address - Fax:
Practice Address - Street 1:28740 US HIGHWAY 98 STE 9
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7207
Practice Address - Country:US
Practice Address - Phone:251-270-2911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094492363LF0000X, 163WG0000X
FL11001979363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty