Healthcare Provider Details

I. General information

NPI: 1003439969
Provider Name (Legal Business Name): TESSA PAINTER SOMERMEYER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 W STATE HIGHWAY 5
WACONIA MN
55387-1795
US

IV. Provider business mailing address

424 W STATE HIGHWAY 5
WACONIA MN
55387-1795
US

V. Phone/Fax

Practice location:
  • Phone: 952-442-4461
  • Fax: 952-442-1547
Mailing address:
  • Phone: 952-442-4461
  • Fax: 952-442-1547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number229123-1
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8895
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: