Provider Demographics
NPI:1649799313
Name:GODWIN, TERINA (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TERINA
Middle Name:
Last Name:GODWIN
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27421 PARK DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-3957
Mailing Address - Country:US
Mailing Address - Phone:251-359-1410
Mailing Address - Fax:
Practice Address - Street 1:401 E CHASE ST STE 200
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6160
Practice Address - Country:US
Practice Address - Phone:850-476-0628
Practice Address - Fax:850-475-1313
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9309027363LP0808X, 363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health