Teresa Lynn Bosacker, NP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R 093070-1 Issued in MN

Practice address

478 2ND St
Excelsior, MN 55331-1987

Phone

(952) 474-3251

Fax

(952) 474-0315

NPI assigned

Jan 30, 2007

Last updated

Sep 11, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1447396940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 WATERFORD LN",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182855",
            "telephone_number": "952-239-4645",
            "fax_number": "952-474-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 2ND ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553311987",
            "telephone_number": "952-474-3251",
            "fax_number": "952-474-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSACKER",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 093070-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Susan Kenney Bonnema
• Andrew Jon Bosworth, D.D.S.
• Katie Marie Moksnes Bowman, LAC
• Daniel Brandon, PT, DPT, ATC
• Annika Cameron
• Camp Smile Orthodontics Excelsior PLLC

• Registered Nurse in Excelsior, MN
• Providers in Excelsior, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.