Healthcare Provider Details

I. General information

NPI: 1033281613
Provider Name (Legal Business Name): TERESA A MULLER APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 SUNNYBROOK DR STE L-200 CARDIOVASCULAR ASSOCIATES PC
SIOUX CITY IA
51106-4203
US

IV. Provider business mailing address

PO BOX 3128 CARDIOVASCULAR ASSOCIATES PC
SIOUX CITY IA
51102-3128
US

V. Phone/Fax

Practice location:
  • Phone: 712-239-4702
  • Fax: 712-239-0616
Mailing address:
  • Phone: 712-239-4702
  • Fax: 712-239-0616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110621
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-104191
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: