Provider Demographics
NPI:1730579335
Name:MCCARTNEY, TERESA (NP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5320 W 23RD ST
Mailing Address - Street 2:STE 130
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1670
Mailing Address - Country:US
Mailing Address - Phone:952-345-3213
Mailing Address - Fax:
Practice Address - Street 1:3500 FRANCE AVE N STE 101
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2882
Practice Address - Country:US
Practice Address - Phone:763-581-5678
Practice Address - Fax:763-581-9341
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR 148248-1363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology