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NPI Code Detail

MEDICARE: THERESA ANN LYBRAND APN

MEDICARE: THERESA ANN LYBRAND APN
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
1363LF0000XFamily Nurse PractitionerA03561AR

General Provider Information

NPI Number : 1659663250
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA ANN LYBRAND APN
Provider Business Mailing Address
First Line : 1402 N PIERCE ST APT E8
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72207-5368
Country : US
Telephone Number : 501-612-2122
Fax Number :
Provider Business Practice Location Address
First Line : 105 FRANKIE LN
Second Line :
City : WHITE HALL
State : AR
Zip : 71602-2685
Country : US
Telephone Number : 870-247-6160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2011
Last Update Date : 04/09/2018

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Directions to “ THERESA ANN LYBRAND APN” Practice Location

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