Individual provider Active NPI

Mary Teresa Stetzel, CNP

  • Women's Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1437163060
Registry record updated Oct 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R 094122-4 Issued in MN
Practice address
1965 Ford Pkwy
Saint Paul, MN 55116-1923
Phone
(651) 696-5509
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R 094122-4 MN Primary

Addresses

Primary practice location

1965 Ford Pkwy
Saint Paul, MN 55116-1923

Mailing address

1965 Ford Pkwy
Saint Paul, MN 55116-1923
Phone (651) 696-5640

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

State licenses

LicenseStateTypeSpecialty
R 094122-4MNMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254528000000",
    "number": "1437163060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161923",
            "telephone_number": "651-696-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161923",
            "telephone_number": "651-696-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETZEL",
        "first_name": "MARY",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2009-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "R 094122-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2009; 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.