Provider Demographics
NPI:1942558747
Name:THESING, AMY MARIE (APRN, CNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:THESING
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:ENNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2831 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1712
Practice Address - Country:US
Practice Address - Phone:651-765-5900
Practice Address - Fax:651-765-5901
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020005363L00000X, 363LF0000X
MNCNP2445363LF0000X
MN2445363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily