Individual provider Active NPI

Amy Louise Teasck, RN

  • Psychiatric/Mental Health Registered Nurse
  • Virginia, MN
National Provider Identifier
1083313621
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
1483833 Issued in MN
Practice address
603 9TH St N
Virginia, MN 55792-2319
Phone
(218) 270-5288
Fax
(218) 270-5290
NPI assigned
Mar 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 1483833 MN Primary

Addresses

Primary practice location

603 9TH St N
Virginia, MN 55792-2319

Mailing address

12600 Whitewater Dr Ste 100
Minnetonka, MN 55343-9450
Phone (529) 935-7112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1483833MNMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1083313621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 WHITEWATER DR STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439450",
            "telephone_number": "529-935-7112",
            "fax_number": "952-935-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 9TH ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922319",
            "telephone_number": "218-270-5288",
            "fax_number": "218-270-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEASCK",
        "first_name": "AMY",
        "middle_name": "LOUISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "1483833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.