Provider Demographics
NPI:1801685185
Name:RODRIGUEZ, TERRI (RN)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2939 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-4122
Mailing Address - Country:US
Mailing Address - Phone:251-368-5146
Mailing Address - Fax:
Practice Address - Street 1:200 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-1714
Practice Address - Country:US
Practice Address - Phone:251-368-5146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-202217163WM0102X, 163WN0002X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive CareGroup - Multi-Specialty