Provider Demographics
NPI:1376945170
Name:BRYAN, SEGELLE LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:SEGELLE
Middle Name:LYNN
Last Name:BRYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1802 E 50TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79404-4004
Mailing Address - Country:US
Mailing Address - Phone:806-771-1160
Mailing Address - Fax:806-771-1162
Practice Address - Street 1:1802 E 50TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79404-4004
Practice Address - Country:US
Practice Address - Phone:806-771-1160
Practice Address - Fax:806-771-1162
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2016-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP126406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX388175YTORMedicare UPIN