| Nicole Theisen, CRNA | |
|
3199 Timberwolf Cir Nw, Prior Lake, MN 55372-3271 | |
| (612) 860-6602 | |
| Not Available |
| Full Name | Nicole Theisen |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 3199 Timberwolf Cir Nw, Prior Lake, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164854188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R1718621 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Minnesota Anesthesia Specialists Pllc | 8426423039 | 9 |
| Entity Name | Metropolitan Anesthesia Network Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558314427 PECOS PAC ID: 5698689123 Enrollment ID: O20031118000579 |
| Entity Name | St Francis Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447605514 PECOS PAC ID: 7214821909 Enrollment ID: O20040212000408 |
| Entity Name | Southdale Anesthesiologists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154381804 PECOS PAC ID: 6709842461 Enrollment ID: O20041203000743 |
| Entity Name | Minnesota Anesthesia Specialists Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710693320 PECOS PAC ID: 8426423039 Enrollment ID: O20230413001081 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Theisen, CRNA 3199 Timberwolf Cir Nw, Prior Lake, MN 55372-3271 Ph: (612) 860-6602 | Nicole Theisen, CRNA 3199 Timberwolf Cir Nw, Prior Lake, MN 55372-3271 Ph: (612) 860-6602 |
Mr. Jed W Adams, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1415 Saint Francis Ave, Anesthesiology, Prior Lake, MN 55379 Phone: 952-402-9499 |