Individual provider Active NPI

Victoria Rae Teske, APRN,CNP

  • Adult Health Nurse Practitioner
  • Park Rapids, MN
National Provider Identifier
1124049465
Registry record updated Dec 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP 2769 Issued in MN
Practice address
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone
(218) 732-2800
Fax
(218) 732-2857
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2769MNMDMarriage & Family Therapist
CNP 2769MNMDAdult Health Nurse Practitioner

NPPES NPI Registry

Updated by the provider on Dec 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X CNP 2769 MN Primary

Addresses

Primary practice location

705 Pleasant Ave S
Park Rapids, MN 56470-1440

Mailing address

1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 732-2800

Other identifiers 1

IdentifierTypeStateIssuer
555025400MedicaidMN

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450915200000",
    "number": "1124049465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESKE",
        "first_name": "VICTORIA",
        "middle_name": "RAE",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2015-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "CNP 2769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555025400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; 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.