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Individual
TEAGUE LAWRENCE
Active
Individual
TEAGUE LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
13010100-3102
AZ
163WG0000X
General Practice Registered Nurse
13010100-3102
UT
363L00000X
Nurse Practitioner
Primary
340601
AZ
363LF0000X
Family Nurse Practitioner
Primary
340601
AZ
Other
Enumeration date
10/13/2025
Last updated
08/20/2026
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