Amber Nicole Theisen

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

2015035202 Issued in MO

Practice address

4483 Duncan Ave
Saint Louis, MO 63110-1111

Phone

(314) 454-7055

NPI assigned

Jan 5, 2024

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1720858228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 AUBER DR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630114101",
            "telephone_number": "314-378-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4483 DUNCAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101111",
            "telephone_number": "314-454-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "2015035202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay Dalton Thebeau, ATC
• Clayton E. Thebeau, D.O.
• Kayla Noelle Theberge, LPC
• Heather Theby
• Anne Theiling, PT
• Kevin Lee Theiss, DMD
• Thekey of Missouri LLC
• John Kuriako Thekkedam, PH.D.
• Nimita Thekkepat, PHARM D., MBA
• Elizabeth Ree Thele, M.S., OTR/L

• Critical Care Medicine Registered Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Critical Care Medicine Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.