Active NPI
Victoria Rae Teske, APRN,CNP
- Adult Health Nurse Practitioner
- Park Rapids, MN
National Provider Identifier
1124049465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- CNP 2769
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2769 | MN | MD | Marriage & Family Therapist |
| CNP 2769 | MN | MD | Adult Health Nurse Practitioner |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 555025400 | Medicaid | MN |
NPI Registry JSON
{
"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.