Provider Demographics
NPI:1649378712
Name:BROWN, TERESA LYNNE (APN)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LYNNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:TERESA
Other - Middle Name:LYNNE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7021 KEWANEE AVE
Mailing Address - Street 2:6-104
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:888-622-6755
Mailing Address - Fax:866-622-6755
Practice Address - Street 1:#3 MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:806-355-1313
Practice Address - Fax:806-358-0335
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1842536-02Medicaid
TX1842536-02Medicaid
TX8K3553Medicare PIN