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NPI Code Detail

MEDICARE: THERESE LYNN DEFABIS APRN, ANP-BC

MEDICARE: THERESE LYNN DEFABIS APRN, ANP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner71000314IN
2363L00000XNurse Practitioner226556OK
3363LA2200XAdult Health Nurse Practitioner0038109OH
4363L00000XNurse PractitionerAPRN11037167FL
5363LA2200XAdult Health Nurse PractitionerC-APN.0103422-C-NPCO
6363LA2200XAdult Health Nurse Practitioner71000314AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538250618
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESE LYNN DEFABIS APRN, ANP-BC
Provider Business Mailing Address
First Line : PO BOX 211699
Second Line :
City : EAGAN
State : MN
Zip : 55121-3699
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Provider Business Practice Location Address
First Line : 155 E MARKET ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46204-3294
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 12/19/2025

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