Individual
MRS. TEENA BREWER CARR
Active
Individual
MRS. TEENA BREWER CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5572
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257759732A
GA MEDICAID
GA
01
—
4057881
BCBS OF TN
—
01
—
500029420
RR MEDICARE
—
05
—
Q002600
—
TN
01
—
TN0179
JOHN DEERE
—
Enumeration date
09/07/2005
Last updated
02/02/2017
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