Healthcare Provider Details

I. General information

NPI: 1285780411
Provider Name (Legal Business Name): TERESA L SIERZANT CNS, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 EXCHANGE ST W
SAINT PAUL MN
55102-1004
US

IV. Provider business mailing address

69 EXCHANGE ST W
SAINT PAUL MN
55102-1004
US

V. Phone/Fax

Practice location:
  • Phone: 651-326-3415
  • Fax: 651-232-3518
Mailing address:
  • Phone: 651-326-3415
  • Fax: 651-232-3518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR078693-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: