Healthcare Provider Details

I. General information

NPI: 1730579335
Provider Name (Legal Business Name): TERESA MCCARTNEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 RIDGEWOOD CV
MINNETRISTA MN
55364-8239
US

IV. Provider business mailing address

5520 RIDGEWOOD CV
MINNETRISTA MN
55364-8239
US

V. Phone/Fax

Practice location:
  • Phone: 800-873-0561
  • Fax: 800-314-2891
Mailing address:
  • Phone: 800-873-0561
  • Fax: 800-314-2891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR 148248-1
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR 148248-1
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: