Provider Demographics
NPI:1295161271
Name:SWISHER, TERRI BROOKE (ANP)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:BROOKE
Last Name:SWISHER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208354
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-8354
Mailing Address - Country:US
Mailing Address - Phone:512-485-7208
Mailing Address - Fax:855-277-5070
Practice Address - Street 1:15801 W HWY 71 STE 200
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-2704
Practice Address - Country:US
Practice Address - Phone:512-485-7200
Practice Address - Fax:855-277-5070
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657166363LA2200X
TXAP124243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health