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General NPI Number Information
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NPI Number | 1790018935
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Entity Type | Individual
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Provider Name | THERESA ANN MEHRMAN CNP
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Gender | Female
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 3720 W 69TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-8192
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Country | US
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Telephone | 605-322-5290
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Fax | 605-322-5252
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Provider Business Mailing Address
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Address Line | 3720 W 69TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-8192
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Country | US
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Telephone | 605-322-5290
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Fax | 605-322-5252
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CP000564
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License Number State | SD
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