Individual
MRS. TERENA S STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
65345 HWY 17, DETROIT, AL 35552
(205) 273-4056
(205) 273-4058
Mailing address
123 MAIN ST N, AMORY, MS 38821-3416
(662) 256-7112
(662) 256-7116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-081469
AL
363LF0000X
Family Nurse Practitioner
2005009897-22
AL
363LF0000X
Family Nurse Practitioner
R857697
MS
Other
Enumeration date
05/12/2006
Last updated
09/24/2012
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