Provider Demographics
NPI:1326103110
Name:CHENEVERT, THERESE M (CNNP)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:M
Last Name:CHENEVERT
Suffix:
Gender:F
Credentials:CNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:HEALTH PARTNERS PHYSICIAN SERVICES
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-6212
Mailing Address - Fax:952-883-9662
Practice Address - Street 1:6500 EXCELSIOR BLVD
Practice Address - Street 2:PARK NICOLLET METHODIST HOSPITAL
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4702
Practice Address - Country:US
Practice Address - Phone:952-993-5318
Practice Address - Fax:952-993-5345
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR1018172363L00000X, 363LN0000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care