Individual
BRANDI LYNNETTE TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1600 N MAIN ST, LOVINGTON, NM 88260
(575) 396-6611
(575) 396-5640
Mailing address
1600 N MAIN ST, LOVINGTON, NM 88260
(575) 396-6611
(575) 396-5640
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP134377
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP-03427
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
66806569
—
NM
Enumeration date
07/26/2017
Last updated
05/08/2024
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