Teresa Ladean Broeker, BSN-RN
Individual provider Active NPI School Registered Nurse · Clovis, NM
NPI 1760104335 · NPPES record last updated Sep 12, 2022
Key facts
- NPI
- 1760104335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- R39862 (TX)
- Practice address
- 1600 Sutter PL
Clovis, NM 88101-4611 - Phone
- (575) 769-4490
- Fax
- (575) 769-4430
- NPI assigned
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R39862 | TX | MD | School Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clovis Municipal Schools | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | R39862 | TX | Yes |
Addresses
Primary practice location
1600 Sutter PL
Clovis, NM 88101-4611
Mailing address
PO Box 19000
Clovis, NM 88102-9000
Phone (575) 769-4490
Other providers in Clovis, NM
- McKenzie Brazile
- Majlis Breath
- Brian a. Zarikta, DDS
- Loveta Rae Briscoe
- Madison Brochu
- Hannah L Brooks
- Nakiyda Brooks
- Roberta Brooks
- Sheila Broome
- Chandra E Brown
All providers in Clovis, NM · School Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.