Teresa Kerubo Nyakundi

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2474188 Issued in MN

Practice address

17863 Essex LN
Lakeville, MN 55044-4825

Phone

(612) 735-0182

NPI assigned

Sep 9, 2025

Reactivated

Dec 8, 2025

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Dec 8, 2025.

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1962383752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17863 ESSEX LN",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17863 ESSEX LN",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444825",
            "telephone_number": "612-735-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAKUNDI",
        "first_name": "TERESA",
        "middle_name": "KERUBO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-12-08",
        "certification_date": "2025-09-09",
        "deactivation_date": "2025-09-10",
        "reactivation_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2474188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lakeville, MN
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.