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NPI Code Detail

MEDICARE: THERESA MASONBRINK APRN, CNS

MEDICARE: THERESA MASONBRINK APRN, CNS
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0024185167VA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner4704276138MI
3363LP0808XPsychiatric/Mental Health Nurse Practitioner101.0136168TELEVT
4364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist5031CA
5363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNS.11227OH

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 : 1770805277
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA MASONBRINK APRN, CNS
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 216-468-5000
Fax Number :
Provider Business Practice Location Address
First Line : 25111 COUNTRY CLUB BLVD STE 290
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-5330
Country : US
Telephone Number : 216-468-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2010
Last Update Date : 07/08/2025

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