Provider Demographics
NPI:1609267806
Name:MUELLER, THERESA (APRN)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15106 W 83RD ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1522
Mailing Address - Country:US
Mailing Address - Phone:913-548-3734
Mailing Address - Fax:
Practice Address - Street 1:7050 W 107TH ST STE 10
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1921
Practice Address - Country:US
Practice Address - Phone:816-682-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76653-042363LP0808X
MO2015002659363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health