Nicole Theisen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R1718621 Issued in MN

Practice address

3199 Timberwolf Cir NW
Prior Lake, MN 55372-3271

Phone

(612) 860-6602

NPI assigned

Aug 1, 2013

Last updated

Jan 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Anesthesia Specialists PLLCGroup PAC ID 8426423039, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minnesota Anesthesia Specialists PLLC

  • Anesthesiology Physician
  • Chaska, MN
  • NPI 1710693320
  Medicare reassignment Care Compare group NPD
• Metropolitan Anesthesia Network, LLP

  • Anesthesiology Physician
  • Plymouth, MN
  • NPI 1558314427

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Southdale Anesthesiologists, LLC

  • Anesthesiology Physician
  • Edina, MN
  • NPI 1154381804
  Medicare reassignment NPD
• St. Francis Regional Medical Center

  dba St. Francis Urgent Care - Southbridge

  • Urgent Care Clinic/Center
  • Shakopee, MN
  • NPI 1447605514
  Medicare reassignment NPD
• St Francis Regional Medical Center

  dba St Francis Regional Medical Center CRNA

  • Certified Registered Nurse Anesthetist
  • Shakopee, MN
  • NPI 1750325965

  Nurse Anesthetist, Certified Registered

  NPD
• Allina Health System

  dba Abbott Northwestern Hospital

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1760446256
  NPD (past)

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1164854188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3199 TIMBERWOLF CIR NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723271",
            "telephone_number": "612-860-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3199 TIMBERWOLF CIR NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723271",
            "telephone_number": "612-860-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1718621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Stotz, MA, LPCC, R-DMT
• Sarah Strayer, IBCLC
• Noah Strom
• Suite Living of Prior Lake
• Debra Kay Sumner, DDS
• Julie Marie Thompson, RN
• Thrive Therapy Center
• Gillian Tibbetts, PSYD
• Tonya Wilhelm Therapy and Consulting PA (Wilhelm Therapy & Consulting)
• Touching Lives Community, Inc.

• Certified Registered Nurse Anesthetist in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.