Individual
MS. BETTY JEAN BROWN-TRASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-BC, FNP-C
Contact information
Practice address
3310 LIVE OAK ST, DALLAS, TX 75204-6153
(214) 266-1257
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP102205
TX
363LP0200X
Pediatric Nurse Practitioner
524863
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108059003
—
TX
05
—
108059007
—
TX
05
—
108059008
—
TX
01
—
8Y0761
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/12/2006
Last updated
02/10/2022
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