Provider Demographics
NPI:1184627002
Name:MCDOWELL, TERESA BETH (CRNP)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:BETH
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 TARILTON RD
Mailing Address - Street 2:
Mailing Address - City:TITUS
Mailing Address - State:AL
Mailing Address - Zip Code:36080-3722
Mailing Address - Country:US
Mailing Address - Phone:334-514-6911
Mailing Address - Fax:
Practice Address - Street 1:1 PLASTICS DR
Practice Address - Street 2:
Practice Address - City:BURKVILLE
Practice Address - State:AL
Practice Address - Zip Code:36752-4001
Practice Address - Country:US
Practice Address - Phone:334-832-5030
Practice Address - Fax:334-832-5008
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-079531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP70687Medicare UPIN