MEDICARE: TERESA MANNING APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP139605	TX
2	363LF0000X	Family Nurse Practitioner	AP139605	TX

General Provider Information

NPI Number	:	1689149858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA MANNING APRN, FNP-C

Provider Business Mailing Address
First Line	:	3025 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2902
Country	:	US
Telephone Number	:	833-696-2329
Fax Number	:

Provider Business Practice Location Address
First Line	:	3025 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2902
Country	:	US
Telephone Number	:	833-696-2329
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	03/15/2025

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