Provider Demographics
NPI:1255450458
Name:BROWN-SANCHEZ, TERESA S (FNP)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:S
Last Name:BROWN-SANCHEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 S SLIGO ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-4718
Mailing Address - Country:US
Mailing Address - Phone:970-564-4855
Mailing Address - Fax:
Practice Address - Street 1:418 S SLIGO ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-4718
Practice Address - Country:US
Practice Address - Phone:970-565-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO150251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82728861Medicaid
CO82728861Medicaid