Healthcare Provider Details

I. General information

NPI: 1669401345
Provider Name (Legal Business Name): ELLEN S TEIGLAND MS, APRN, BC, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 NE 3RD ST
GRAND RAPIDS MN
55744-2742
US

IV. Provider business mailing address

25 NE 3RD ST
GRAND RAPIDS MN
55744-2742
US

V. Phone/Fax

Practice location:
  • Phone: 218-326-7089
  • Fax: 218-327-3173
Mailing address:
  • Phone: 218-326-7089
  • Fax: 218-327-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP2283
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: