Individual
THERESA MARIE CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNS
Contact information
Practice address
332 W SUPERIOR ST, SUITE 300, DULUTH, MN 55802-1808
(218) 722-4379
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNS0322
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
953172600
—
MN
Enumeration date
07/18/2006
Last updated
02/27/2017
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