Theresa Rae Reese, APRN, PNP-PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5044 Issued in MN

Practice address

3381 Spring Glen Cir NW
Prior Lake, MN 55372-1752

Phone

(651) 434-9753

NPI assigned

Mar 2, 2017

Sex

Female

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• Sunrise Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Owatonna, MN
  • NPI 1649050162

  Pediatrics

  NPD Authorized official
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1508306044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 SPRING GLEN CIR NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721752",
            "telephone_number": "651-434-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3381 SPRING GLEN CIR NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721752",
            "telephone_number": "651-434-9753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 N Cedar Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "550602306",
            "country_code": "US",
            "telephone_number": "651-434-9753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REESE",
        "first_name": "THERESA",
        "middle_name": "RAE",
        "credential": "APRN, PNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R2052469-8",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "5044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prior Lake Ops LLC
• Prior Lake Spine Health & Injury Center, PLLC
• Prior Lake-Savage Independent School District #719
• Charles Walter Puffer, DDS
• Redwood Counseling LLC
• Lauren Emily Resh, PHARMD
• Resilient Fusion
• Nicholas David Restifo
• Alyssa Ricke
• Joshua R Rickert, D.C.

• Psychiatric/Mental Health Nurse Practitioner in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.