Individual
VICKY L THERKILDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1811 WEIR DR STE 270, WOODBURY, MN 55125-6741
(651) 714-9646
(651) 714-9647
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3034
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R 211111-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R 211111 - 7
MEDICAL LICENSE
MN
Enumeration date
12/03/2009
Last updated
01/17/2018
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